In-Toeing Is Often a Primary Care Orthopedic Condition

John A. Sielatycki, William L. Hennrikus, Richard D. Swenson, Matthew G. Fanelli, Cynthia J. Reighard, Jane A. Hamp

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective To evaluate in-toeing consults to a pediatric orthopedic clinic to determine the proportion that could be managed by a primary care physician. Study design A prospective registry was created for 143 consecutive children referred to a pediatric orthopedic clinic for “in-toeing.” Each patient underwent a careful history and physical examination, which included a rotational profile. We recorded the final diagnosis, treatment offered, follow-up visit results, and the source of the referral. Results After pediatric orthopedic evaluation, 85% of patients had a confirmed diagnosis of in-toeing, and 15% had a different final diagnosis. Seventy-four percent of patients had 1 consultation visit, 18% had 2, and 8% had >2 visits. None of the referred patients was a candidate for treatment by casting or surgery. Conclusion In most cases, in-toeing is a normal variation of development that can be managed by counseling and observation by the primary care physician alone. Rare cases of severe in-toeing >2 standard deviations from the mean should likely still prompt referral to a pediatric orthopedic surgeon for potential intervention.

Original languageEnglish (US)
Pages (from-to)297-301
Number of pages5
JournalJournal of Pediatrics
Volume177
DOIs
StatePublished - Jan 1 2016

Fingerprint

Orthopedics
Primary Health Care
Pediatrics
Referral and Consultation
Primary Care Physicians
Physical Examination
Registries
Counseling
History
Observation
Metatarsus Varus
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Sielatycki, J. A., Hennrikus, W. L., Swenson, R. D., Fanelli, M. G., Reighard, C. J., & Hamp, J. A. (2016). In-Toeing Is Often a Primary Care Orthopedic Condition. Journal of Pediatrics, 177, 297-301. https://doi.org/10.1016/j.jpeds.2016.06.022
Sielatycki, John A. ; Hennrikus, William L. ; Swenson, Richard D. ; Fanelli, Matthew G. ; Reighard, Cynthia J. ; Hamp, Jane A. / In-Toeing Is Often a Primary Care Orthopedic Condition. In: Journal of Pediatrics. 2016 ; Vol. 177. pp. 297-301.
@article{bc70630354044379b6aaa33e2401dba4,
title = "In-Toeing Is Often a Primary Care Orthopedic Condition",
abstract = "Objective To evaluate in-toeing consults to a pediatric orthopedic clinic to determine the proportion that could be managed by a primary care physician. Study design A prospective registry was created for 143 consecutive children referred to a pediatric orthopedic clinic for “in-toeing.” Each patient underwent a careful history and physical examination, which included a rotational profile. We recorded the final diagnosis, treatment offered, follow-up visit results, and the source of the referral. Results After pediatric orthopedic evaluation, 85{\%} of patients had a confirmed diagnosis of in-toeing, and 15{\%} had a different final diagnosis. Seventy-four percent of patients had 1 consultation visit, 18{\%} had 2, and 8{\%} had >2 visits. None of the referred patients was a candidate for treatment by casting or surgery. Conclusion In most cases, in-toeing is a normal variation of development that can be managed by counseling and observation by the primary care physician alone. Rare cases of severe in-toeing >2 standard deviations from the mean should likely still prompt referral to a pediatric orthopedic surgeon for potential intervention.",
author = "Sielatycki, {John A.} and Hennrikus, {William L.} and Swenson, {Richard D.} and Fanelli, {Matthew G.} and Reighard, {Cynthia J.} and Hamp, {Jane A.}",
year = "2016",
month = "1",
day = "1",
doi = "10.1016/j.jpeds.2016.06.022",
language = "English (US)",
volume = "177",
pages = "297--301",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",

}

Sielatycki, JA, Hennrikus, WL, Swenson, RD, Fanelli, MG, Reighard, CJ & Hamp, JA 2016, 'In-Toeing Is Often a Primary Care Orthopedic Condition', Journal of Pediatrics, vol. 177, pp. 297-301. https://doi.org/10.1016/j.jpeds.2016.06.022

In-Toeing Is Often a Primary Care Orthopedic Condition. / Sielatycki, John A.; Hennrikus, William L.; Swenson, Richard D.; Fanelli, Matthew G.; Reighard, Cynthia J.; Hamp, Jane A.

In: Journal of Pediatrics, Vol. 177, 01.01.2016, p. 297-301.

Research output: Contribution to journalArticle

TY - JOUR

T1 - In-Toeing Is Often a Primary Care Orthopedic Condition

AU - Sielatycki, John A.

AU - Hennrikus, William L.

AU - Swenson, Richard D.

AU - Fanelli, Matthew G.

AU - Reighard, Cynthia J.

AU - Hamp, Jane A.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective To evaluate in-toeing consults to a pediatric orthopedic clinic to determine the proportion that could be managed by a primary care physician. Study design A prospective registry was created for 143 consecutive children referred to a pediatric orthopedic clinic for “in-toeing.” Each patient underwent a careful history and physical examination, which included a rotational profile. We recorded the final diagnosis, treatment offered, follow-up visit results, and the source of the referral. Results After pediatric orthopedic evaluation, 85% of patients had a confirmed diagnosis of in-toeing, and 15% had a different final diagnosis. Seventy-four percent of patients had 1 consultation visit, 18% had 2, and 8% had >2 visits. None of the referred patients was a candidate for treatment by casting or surgery. Conclusion In most cases, in-toeing is a normal variation of development that can be managed by counseling and observation by the primary care physician alone. Rare cases of severe in-toeing >2 standard deviations from the mean should likely still prompt referral to a pediatric orthopedic surgeon for potential intervention.

AB - Objective To evaluate in-toeing consults to a pediatric orthopedic clinic to determine the proportion that could be managed by a primary care physician. Study design A prospective registry was created for 143 consecutive children referred to a pediatric orthopedic clinic for “in-toeing.” Each patient underwent a careful history and physical examination, which included a rotational profile. We recorded the final diagnosis, treatment offered, follow-up visit results, and the source of the referral. Results After pediatric orthopedic evaluation, 85% of patients had a confirmed diagnosis of in-toeing, and 15% had a different final diagnosis. Seventy-four percent of patients had 1 consultation visit, 18% had 2, and 8% had >2 visits. None of the referred patients was a candidate for treatment by casting or surgery. Conclusion In most cases, in-toeing is a normal variation of development that can be managed by counseling and observation by the primary care physician alone. Rare cases of severe in-toeing >2 standard deviations from the mean should likely still prompt referral to a pediatric orthopedic surgeon for potential intervention.

UR - http://www.scopus.com/inward/record.url?scp=84979697567&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84979697567&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2016.06.022

DO - 10.1016/j.jpeds.2016.06.022

M3 - Article

C2 - 27470689

AN - SCOPUS:84979697567

VL - 177

SP - 297

EP - 301

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

ER -

Sielatycki JA, Hennrikus WL, Swenson RD, Fanelli MG, Reighard CJ, Hamp JA. In-Toeing Is Often a Primary Care Orthopedic Condition. Journal of Pediatrics. 2016 Jan 1;177:297-301. https://doi.org/10.1016/j.jpeds.2016.06.022