Infants and children often assume certain positions during sleep or while sitting for long periods (watching television) that lead to positional deformities of the femur, tibia, or feet.

Sleeping in the prone, knee-chest position with the legs internally rotated may lead to anteversion of the femoral neck, internal tibial torsion, and varus of the forefoot; having the legs externally rotated may lead to valgus of the feet; and having the legs in a neutral position may lead to equinus of the feet and toe-walking. Sleeping in the prone position with the legs extended and rotated inward may lead to anteversion of the femoral neck, internal tibial torsion, and varus of the forefoot; having them rotated outward may lead to retroversion of the femoral neck and valgus of the feet. Sleeping in the frog-leg position prone or supine may lead to retroversion of the femoral neck and valgus and abduction of the feet.

Sitting in the reversed tailor position with the feet internally rotated may produce anteversion of the femoral neck, internal tibial torsion, and varus of the forefoot; having the feet rotated externally may produce anteversion of the femoral neck and valgus of the feet.

When these sleeping or sitting positions occur in conjunction with the positional deformities listed, and when they raise concern, some effort can be made to change the positional sleeping or sitting habit. Success, however, is not often attained.

Although in-toeing or out-toeing may reflect a variety of underlying orthopedic diseases, no evidence has been found suggesting that in-toeing or out-toeing of developmental origin leads to any functional disabilities if left uncorrected.[15]