Intoeing means that when a child walks or runs, the feet turn inward instead of pointing straight ahead. It is commonly referred to as being "pigeon-toed."
Intoeing is often first noticed by parents when a baby begins walking. In the vast majority of children younger than 8 years old, intoeing will almost always correct itself without the use of casts, braces, surgery, or any special treatment. A child whose intoeing is associated with pain, swelling, or a limp should be evaluated by an orthopaedic surgeon.
There are three common conditions causing intoeing:
•Curved foot (metatarsus adductus)
•Twisted shin (tibia torsion)
•Twisted thighbone (femoral anteversion)
Metatarsus adductus improves by itself most of the time, usually over the first 4 to 6 months of life. Babies aged 6 to 9 months with severe deformity or feet that are very rigid may be treated with casts or special shoes with a high rate of success. Surgery to straighten the foot is seldom required.
Tibial torsion almost always improves without treatment, and usually before school age. Splints, special shoes, and exercise programs do not help. Surgery to re-set the bone may be done in a child who is at least 8 to10 years old and has a severe twist that causes significant walking problems.
Femoral anteversion spontaneously corrects in almost all children as they grow older. Studies have found that special shoes, braces, and exercises do not help. Surgery is usually not considered unless the child is older than 9 or 10 years and has a severe deformity that causes tripping and an unsightly gait. Like surgery for tibial torsion, during the procedure for femoral anteversion, the femur is cut and rotated back into proper alignment.
Treatment is mostly Reassurance and Observation
Ref: http://orthoinfo.aaos.org/topic.cfm?topic=a00055
