When to see specialist

August 27, 1991|By New York Times News Service

Children outgrow the vast majority of foot and gait problems, but doctors say several conditions merit consulting an orthopedist.

* Children with a difference in leg lengths of more than a half inch to three-quarters of an inch should be taken to a physician, although opinions vary over how great the discrepancy must be before a shoe lift is considered.

* If a child's bowlegs or knock-knees are especially severe or affect only one leg, a physician should be consulted. Dr. Michelle A. Larson, who studies neuromuscular development at the University of Southern California in Los Angeles, said that many children begin walking with hips and feet turned outward, but that if a child maintains that gait in an exaggerated fashion after six months of toddling, it could indicate hip and joint difficulties that might need a brace or surgery.

* Children who maintain a tiptoe step after six months of walking should also see a doctor, Dr. Larson said. "That could indicate a neuromuscular problem," she said. "Walking with a toe-heel gait too long is one of the first key indications of muscular dystrophy, although that's very rare."

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