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A Novel Classification System for Patients with Persistent ITW

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Abstract

By the age of 3, most children develop a mature gait pattern, defined as plantigrade use of the foot with weightbearing through both the heel and metatarsal heads.

Children with idiopathic toewalking (ITW) are otherwise neurologically normal but preferentially walk on their tiptoes. ITW resolves in most cases by 6 years of age.

Children with persistent ITW (ITWp) may develop ankle contractures and foot skeletal deformities.

The Alvarez criteria was established in 2006 and has since been the standard classification for ITWp based

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