Out-toeing

Out-toeing

Introduction/Etiology/Epidemiology

• Out-toeing is defined as a foot progression angle (FPA) (ie, foot imprint on the ground) outward greater than the upper limit of normal (20 degrees in infancy and 15 degrees at skeletal maturity).

• Out-toeing may stem from the hip, femur, or tibia.

• Pes planus and foot pronation may also contribute to out-toeing.

Diagnosis and Treatment

• External rotation contractures of the hip in infancy

— A common finding in normal infants caused by fetal packaging in utero that results in an externally rotated posture of the lower limb. It is often first noted at the onset of walking.

— The feet turn out when the infant is placed in an upright position; this is sometimes referred to as the Charlie Chaplin stance.

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