Serial casting in the treatment of idiopathic toe-walkers and review of the literature.
Idiopathic toe-walking is defined as persistent toe-walking in a normal child in the absence of developmental, neurological or neuromuscular conditions. True idiopathic toe-walking is a rare referral, representing approximately 1:100 new patients seen in the Paediatric Orthopaedic Clinic. A prospective study of idiopathic toe-walking (ITW) was organised between 1999 and 2003. Patients underwent full history, neurological examination and assessment of ankle dorsiflexion, followed by below-knee weight-bearing casting. Forty four developmentally normal children with no delay in walking age were in this study. There was an age range on presentation from 2 years to 14 years 4 months, with median 60.5 months. Sixty eight percent were male. Thirty four percent had a family history of the condition. Following casting, 66% of patients had improved gait on patient and clinician determined outcomes, with the majority of children ceasing to toe-walk. Ankle dorsiflexion significantly improved in those children who were successfully treated (p = 0.001).
Fox
Anna
A
Blackburn Royal Infirmary, Blackburn, United Kingdom. annafox2k@btopenworld.com
Deakin
Sue
S
Pettigrew
Gill
G
Paton
Robin
R
D000293:Adolescent; D000843:Ankle Joint / Q000502:physiology; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D011446:Prospective Studies