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The effect of persistent toe walking on the skeletal development of the pediatric foot and ankle

Sinclair, Mark, R.a; Lind, Allison, A.a; Knowlton, Joshua, Q.b

Journal of Pediatric Orthopaedics B: January 2018 - Volume 27 - Issue 1 - p 77–81
doi: 10.1097/BPB.0000000000000461

The aim of this study was to determine whether persistent idiopathic toe walking leads to compensatory skeletal changes in the pediatric foot and ankle. Foot radiographs of children diagnosed with idiopathic toe walking and sex-matched and age-matched controls were retrospectively reviewed. Five blinded providers assessed the foot radiographs for skeletal changes to the ankle. The relationship between each measure and toe-walking status was examined. Providers observed radiographic evidence of skeletal changes of the talus in idiopathic toe walkers compared with controls, suggesting that persistent toe walking impacts the skeletal development of the talus. Level of Evidence: prognostic level III

aDivision of Orthopaedics and Sports Medicine

bDepartment of Radiology, Children’s Mercy Hospital, Kansas City, Missouri, USA

Correspondence to Mark R. Sinclair, MD, Children’s Mercy Hospital, Division of Orthopaedics and Sports Medicine, 2401 Gillham Road, Kansas City, MO 64108, USA Tel: +1 816 234 3693; fax: +1 816 855 1993; e-mail:

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