Persistent medial deviation of the neck of the talus: a common cause of in-toeing in children.

We studied 117 in-toed children and found external tibial-fibular torsion and internal axial deviation of the foot from the midsagittal plane. Based on studies of newborn infants, radiographs, and anatomical specimens, we concluded that a major cause of in-toed gait in children was persistence of the fetal medial deviation of the talar neck and not internal tibial torsion. Spontaneous correction can be anticipated in children up to the age of 3 years if the internal axial rotation is less than 10 degrees. If it is greater than 10 degrees, prognosis for correction with orthoses is age related. In children over the age of 6 years, little correction seems possible.