title: Idiopathic toe walking.
abstract: Toe walking is a bilateral gait abnormality in which a normal heel strike is absent and most weight bearing occurs through the forefoot. This abnormality may not be pathologic in patients aged <2 years, but it is a common reason for referral to an orthopaedic surgeon. Toe walking can be caused by several neurologic and developmental abnormalities and may be the first sign of a global developmental problem. Cases that lack a definitive etiology are categorized as idiopathic. A detailed history, with careful documentation of the developmental history, and a thorough physical examination are required in the child with a primary report of toe walking. Treatment is based on age and the severity of the abnormality. Management includes observation, stretching, casting, bracing, chemodenervation, and surgical lengthening of the gastrocnemius-soleus complex and/or Achilles tendon. An understanding of idiopathic toe walking as well as treatment options and their outcomes can help the physician individualize treatment to achieve optimal results.
authors.affiliation: Department of Orthopaedic Surgery, Children's National Medical Center, Washington, DC, USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Oetgen
authors.forename: Sean
authors.initials: S
authors.lastname: Peden
mesh_terms: D005684:Gait / Q000502:physiology*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014034:Toes / Q000502:physiology; D016138:Walking / Q000502:physiology*