Metatarsus adductus, or metatarsus varus, is a common foot deformity present at birth that causes the front half of the foot to turn inward. This condition can be flexible, meaning the foot can be straightened by hand, or non-flexible, meaning the foot cannot be straightened by hand.
The cause of metatarsus adductus is not known and occurs in one out of every 1,000 or 2,000 live births, affecting boys and girls evenly. Causal factors include a family history of metatarsus adductus, the position of the baby in the uterus, especially with breech babies, and the sleeping position of the baby (babies sleeping on their stomach sometimes increase the tendency to turn their feet outward).
Babies born with metatarsus adductus may be at an increased risk of having a related hip condition called developmental dysplasia of the hip (DDH). DDH is when the hip joint slips in and out of its socket, because the socket is too shallow to keep the joint intact.
Diagnosis is through a physical examination, where the doctor will ask if any other family members have metatarsus adductus. X-rays are taken in cases of non-flexible metatarsus adductus.
Infants with metatarsus adductus have high arches and the big toe has a wide separation from the second toe and deviates inward. Flexible metatarsus adductus is diagnosed when the heel and forefoot can be aligned with each other with gentle pressure on the forefoot while holding the heel steady. If the heel is difficult to align with the heel, it is considered non-flexible, or stiff foot.
Treatment for metatarsus adductus is based on:
- Your child's age, overall health, and medical history
- Extent of the deformity
- Your child's tolerance for certain medications, procedures, or therapies
- Expectations of the course of treatment
- Your opinion or preference
The goal of treatment is to straighten the position of the forefoot and heel. There are various options, including:
- Observation for those with flexible forefoot
- Stretching or passive manipulation exercises
Metatarsus adductus may suddenly resolve itself without any medical intervention.
Your doctor will instruct you in passive manipulation exercises on their feet while diaper changing and will recommend changing their sleeping position.
In rare cases where stretching and manipulation exercises do not work, long leg casts will be applied. Casts are used to stretch the soft tissues of the forefoot and are changed every one to two weeks. If the foot responds to casting, straight cast shoes will be prescribed to hold the forefoot in place. This cast is made without a curve in the bottom of the foot. Infants with very severe metatarsus adductus will require surgery to release the forefoot joints.
With treatment, this condition can be resolved and the child can live without pain in their foot.
If you believe have a foot problem and do not currently see a podiatrist, call one of our six locations to make an appointment.
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