This condition can affect one or both feet. The purpose of the orthopaedic examination is to rule out other conditions that may resemble metatarsus adductus, and to evaluate the flexibility of the foot. Depending on how flexible the foot is, stretching exercises at each diaper change may be recommended. Internal tibial torsion is the most common cause of intoeing in the toddler. Although it is usually seen in both legs, one is often worse than the other.
Parents often notice that the intoeing is worse at the end of the day, when the child is tired.
Internal tibial torsion is most often present when the child is from 3 to 24 months of age. The purpose of the orthopaedic examination is to rule out other conditions that have internal tibial torsion as an element. It usually resolves itself without any treatment by two years of age. In rare instances, bracing may be recommended. In very rare cases, severe torsion may persist in the older child, and surgical correction may be suggested.