The Journal of Pediatrics
Volume 157, Issue 3 , Pages 496-498 , September 2010

Early Onset Toe-Walking in Toddlers: A Cause for Concern?

  • Julie Pernet, MD

      Affiliations

    • Department of Pediatric Emergency Care, APHP-University Hospital R. Debré, Paris, France
    • Contributed equally.
    • ,
  • Amandine Billiaux, MD

      Affiliations

    • Department of Pediatric Emergency Care, APHP-University Hospital R. Debré, Paris, France
    • Contributed equally.
    • ,
  • Stéphane Auvin, MD, PhD

      Affiliations

    • Department of Pediatric Neurology, APHP-University Hospital R. Debré, Paris, France
    • ,
  • Domohina Rakatovao, MD

      Affiliations

    • Department of Pediatric Emergency Care, APHP-University Hospital R. Debré, Paris, France
    • ,
  • Laurence Morin, MD

      Affiliations

    • Department of Pediatric Emergency Care, APHP-University Hospital R. Debré, Paris, France
    • ,
  • Ana Presedo, MD

      Affiliations

    • Department of Pediatric Orthopedics, APHP-University Hospital R. Debré, Paris, France
    • ,
  • Jean-Christophe Mercier, MD, PhD

      Affiliations

    • Department of Pediatric Emergency Care, APHP-University Hospital R. Debré, Paris, France
    • ,
  • Luigi Titomanlio, MD, PhD

      Affiliations

    • Department of Pediatric Emergency Care, APHP-University Hospital R. Debré, Paris, France
    • Department of Pediatric Neurology, APHP-University Hospital R. Debré, Paris, France
    • Corresponding Author InformationReprint requests: Luigi Titomanlio, MD, PhD, Pediatric Emergency Department, Robert Debré University Hospital, 48, Bld Sérurier - 75019 Paris, France.

Received 16 December 2009 ,Revised 26 February 2010 ,Accepted 28 April 2010.

References 

  1. Sutherland DH, Olshen R, Cooper L, Woo SL. The development of mature gait. J Bone Joint Surg Am. 1980;62:336–353
  2. Madrid RE, Kubisch C, Hays AP. Early-onset toe walking in rippling muscle disease due to a new caveolin-3 gene mutation. Neurology. 2005;65:1301–1303
  3. Shield LK. Toe walking and neuromuscular disease. Arch Dis Child. 1984;59:1003–1004
  4. Newman CJ, Ziegler AL, Jeannet PY, Roulet-Perez E, Deonna TW. Transient dystonic toe-walking: differentiation from cerebral palsy and a rare explanation for some unexplained cases of idiopathic toe-walking. Dev Med Child Neurol. 2006;48:96–102
  5. Ming X, Brimacombe M, Wagner GC. Prevalence of motor impairment in autism spectrum disorders. Brain Dev. 2007;29:565–570
  6. Sala DA, Shulman LH, Kennedy RF, Grant AD, Chu ML. Idiopathic toe-walking: a review. Dev Med Child Neurol. 1999;41:846–848
  7. Fox A, Deakin S, Pettigrew G, Paton R. Serial casting in the treatment of idiopathic toe-walkers and review of the literature. Acta Orthop Belg. 2006;72:722–730
  8. Bottos M, Benedetti MG, Salucci P, Gasparroni V, Giannini S. Botulinum toxin with and without casting in ambulant children with spastic diplegia: a clinical and functional assessment. Dev Med Child Neurol. 2003;45:758–762
  9. Lee JH, Sung IY, Yoo JY, Park EH, Park SR. Effects of different dilutions of botulinum toxin type A treatment for children with cerebral palsy with spastic ankle plantarflexor: a randomized controlled trial. J Rehabil Med. 2009;41:740–745
  10. McMulkin ML, Baird GO, Caskey PM, Ferguson RL. Comprehensive outcomes of surgically treated idiopathic toe walkers. J Pediatr Orthop. 2006;26:606–611
  11. Chen L, Greisberg J. Achilles lengthening procedures. Foot Ankle Clin. 2009;14:627–637
  12. Hemo Y, Macdessi SJ, Pierce RA, Aiona MD, Sussman MD. Outcome of patients after Achilles tendon lengthening for treatment of idiopathic toe walking. J Pediatr Orthop. 2006;26:336–340
  13. Accardo P, Morrow J, Heaney MS, Whitman B, Tomazic T. Toe walking and language development. Clin Pediatr (Phila). 1992;31:158–160
  14. Hirsch G, Wagner B. The natural history of idiopathic toe-walking: a long-term follow-up of fourteen conservatively treated children. Acta Paediatr. 2004;93:196–199
  15. Eastwood DM, Menelaus MB, Dickens DR, Broughton NS, Cole WG. Idiopathic toe-walking: does treatment alter the natural history?. J Pediatr Orthop B. 2000;9:47–49
  16. Stricker SJ, Angulo JC. Idiopathic toe walking: a comparison of treatment methods. J Pediatr Orthop. 1998;18:289–293
  17. Kogan M, Smith J. Simplified approach to idiopathic toe-walking. J Pediatr Orthop. 2001;21:790–791

 The authors declare no conflicts of interest.

PII: S0022-3476(10)00389-6

doi: 10.1016/j.jpeds.2010.04.070

The Journal of Pediatrics
Volume 157, Issue 3 , Pages 496-498 , September 2010

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