Thoughts on in-toeing and out-toeing: twenty years' experience with over 5000 cases and a review of the literature.

We are reporting over 5000 cases of children presenting with toeing-in or toeing-out problems. Patients were seen over a period of 20 years. The toeing-in and toeing-out gait patterns are discussed in terms of the relationship to the hip joint and the tibiofibular unit. It is concluded by the authors that most of these problems represent normal variants in the development of the child and require no treatment. The necessity and modalities of therapy for the remainder are discussed in detail. The current literature on the subject is also reviewed.