Do children who in-toe need to be referred to an orthopaedic clinic?

The objective of this study was to investigate the outcome of in-toeing referrals to a paediatric orthopaedic department. Two hundred and two patients referred to the Royal Hospital for Sick Children, Edinburgh between July 2005 and March 2008 were retrospectively reviewed. Increased femoral anteversion and internal tibial torsion formed the majority of diagnoses. The median age of referral was 4 years. No patient in the audit period required surgery. Eighty-six percent of children were discharged after their first visit. No significant pathology was identified in the 14% reviewed. Management and outcome for these children were not affected by referral to the orthopaedic clinic.