II. Epidemiology

  1. Less common than In-Toeing

III. Epidemiology

  1. Common disorder in newborn

IV. Pathophysiology

  1. Typically related to hip contracture from intrauterine positioning

V. Signs

  1. Feet externally rotated (Out-toeing) nearly 90 degrees (charlie chaplin walk)
  2. Hip internal rotation decreased
  3. Hip external rotation increased

VI. Imaging

  1. Indicated in persistent findings after age 3 years
  2. Obtain xray Pelvis, XRay Hip and xray lower extremity

VII. Management

  1. Referral to pediatric orthopedics if persistent findings after age 3 years old
  2. Typical age of surgical corrective osteotomy is 10 years old

VIII. Course

  1. Typical improvement in the first year of walking
  2. Persistent findings after 3 years warrants investigation

IX. Associated Conditions

  1. Slipped Capital Femoral Epiphysis (if persists >age 8 years old)
  2. Leg Stress Fracture

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