Idiopathic toe-walking: does treatment alter the natural history?

J Pediatr Orthop B. 2000 Jan;9(1):47-9. doi: 10.1097/01202412-200001000-00010.


Outcomes from observation or cast or surgical treatment of idiopathic toe-walking were determined in 136 children. With patient-determined outcomes, for the observation group, gait was normal in 6%, improved in 45%, and unchanged in 49%. Physician-determined outcomes demonstrated normal gait in 12% of children. Outcomes were similar in the cast group. With patient-determined outcomes in the surgical group, 22% walked normally, 50% had improved, 26% were unchanged, and 2% had deteriorated; with physician-determined outcomes, 37% walked normally. The natural history, determined from the observation group, was for idiopathic toe-walking to persist, albeit with improvement in 50%. Cast treatment did not alter the natural history. Surgical treatment may influence the outcome, but indications for surgery need to be clarified.

MeSH terms

  • Achilles Tendon / abnormalities*
  • Achilles Tendon / surgery
  • Child
  • Child, Preschool
  • Female
  • Gait*
  • Humans
  • Infant
  • Male
  • Toes*
  • Treatment Outcome