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It has occasionally been termed “monkey-toeing” due to the peculiar deviation of the great toe medially resembling that seen in arboreal apes, while the lateral four toes tend to be pointing in a straight position. The condition is most commonly seen from birth to 18 months and may persist until three years of age. It is characterized by a flexible medial deviation of the great toe, not unlike that seen in primates with a prehensile first digit. 6). The natural propensity for metatarsus adductus is to resolve spontaneously, and this casts doubt on the wisdom of using any active treatment.

From 24 months onward, children normally will enter a stage of increasing valgus at the knees and this generally will persist until adolescence, at which time they seem to follow a pattern of their genetic inheritance, eventually culminating into a pattern of knees that are either straight or with very minor degrees of varus or valgus. 4). 3. Graph demonstrating physiologic progression of varus to valgus. SM: Skeletal Maturity. 4. The technique of measurement by finger-breadths of genu varum and genu valgum.

It is also more comfortable for them to walk internally rotated during gait, particularly when they are tired or running. Personal experience, using computed tomography scanning, does not support any increase in the bending of the upper end of the bony femur in relationship to the acetabulum (anteversion), an anatomic event erroneously attributed to the etiology. It is paradoxical that at birth, when true bony anteversion is at the greatest degree in the human, the range of external rotation of the hip is the greatest, as it will be throughout the first year of life.

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