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Sorry re my lack of posts. Would love some advice for this.
I have a patient , 17 month old boy, who has significant out toeing of both feet when he stands(about 50-80 degrees in both feet.) he does not walk yet but is able to walk a little while holding on to furniture. 5 or 6 steps then he stops.
On examination he has signicantly more hip external rotation with hips extended and flexed(Up to 80 degrees) with significantly less internal rotation.
I am fairly sure that tibial external torsion is not a problem. However while he is standing in such an out toed position it places pressure on his feet which may contribute to forefoot abduction and perhaps tibial torsion.
His feet stand in a very pronated position which is not helped by the abducted position of his legs.
Developmentally: late crawler(13 months); saying a few words at moment; reasonably good hand eye coordination; happy disposition; in 90th percentile for height and weight; doesn't seem keen to walk, happy to crawl; now has fairly good upper and lower body strength. No problems with birth or post natally.
Nerological: Plantar flexed first rays; flexes toes when rubbing finger along plantar surface; normal Achilles tendon and knee reflexes.
I haven't really suggested anything yet. Using this period as a window period as a prewalker really. I would say hip exercises would be warranted but I am stuck after this?
Does anyone out there have any thoughts?