Idiopathic Toe‐Walking: Does Treatment Alter the Natural History?

&NA; Outcomes from observation or cast or surgical treatment of idiopathic toe‐walking were determined in 136 children. With patient‐determined outcomes, for the observation group, gait was normal in 6%, improved in 45%, and unchanged in 49%. Physician‐determined outcomes demonstrated normal gait in 12% of children. Outcomes were similar in the cast group. With patient‐determined outcomes in the surgical group, 22% walked normally, 50% had improved, 26% were unchanged, and 2% had deteriorated; with physician‐determined outcomes, 37% walked normally. The natural history, determined from the observation group, was for idiopathic toe‐walking to persist, albeit with improvement in 50%. Cast treatment did not alter the natural history. Surgical treatment may influence the outcome, but indications for surgery need to be clarified.