Q. Our 6-month-old son's left foot is turned inward. I'm worried that it will cause problems when he starts to walk. Is there anything I can do now to help him? Would special shoes correct this problem? Does he need any other kind of treatment?

A. Most cases of in-toeing (feet turned inward) correct by themselves and don't require any treatment. However, your son's doctor should examine him to make sure he doesn't need any special treatment.

Three conditions account for the majority of causes of in- toeing. The problem may lie in the foot itself, the shin bone or the hip joint. The medical terms for these conditions are metatarsus adductus, tibial torsion and femoral anteversion.

In metatarsus adductus, the bones of the foot are turned inward. The condition most often stems from a slight bending of these bones in the cramped confines of the uterus. Most cases get better by themselves; or, your doctor may advise you to gently stretch the foot back into a straighter position, every time you change your son's diapers, for example.

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But if the foot is severely curved and can't be straightened, your son may benefit from having it put into a cast or plastic brace for a few weeks at a time. Once the foot straightens out, no further treatment is usually needed.

Tibial torsion refers to a slight twisting of the shin bone (tibia) on its long axis. This twisting turns the foot inward, although the foot itself is normal. Tibial torsion is actually a normal state in newborns. Almost all children will "straighten out" by the time they're in grade school, if not well before -- after they've been walking for a while.

Night splints have been used to speed up the straightening process, but research doesn't show that they work especially well. For most children, simply letting them outgrow this condition is probably best. Children with severe degrees of tibial torsion will need surgery to correct the problem, although it's rare to use surgery just to make the feet look straight.

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Femoral anteversion refers to a turning of the hip joint that causes the foot to turn inward. This condition is the most common cause of in-toeing. As with the other two, it tends to get better by itself during early childhood.

Short of hip surgery, there's no good treatment for femoral anteversion. In the rare cases when it is done, the child is usually 8 to 10 years old. However, research shows no difference in leg function. Affected children run just as fast, jump just as far and move just as well as children without this condition.

Aside from a few rare causes of in-toeing having to do with nerve problems in the spine, the three common conditions I've discussed are minor variations of normal that usually correct by themselves. They almost never cause any problems in your child's abilities, or lead to any harm. At worst, they're a temporary cosmetic nuisance that may be treated to improve your child's appearance. But in most cases, although you might feel the need to "do something" about the in-toeing, the best thing to do is let it get better on its own.

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Jay Siwek, a family physician from Georgetown University, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington.

Consultation is a health education column and is not a substitute for medical advice from your physician.

Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071. Questions cannot be answered individually.

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