Metatarsus adductus is a foot deformity. The bones in the middle of the foot bend in toward the body.
Alternative NamesMetatarsus varus; Forefoot varus
Causes, incidence, and risk factorsMetatarsus adductus is thought to occur as a result of the infant's position inside the womb.
This is a relatively common disease affecting about one out of every 1,000 to 2,000 live births. Risk factors may include a condition called oligohydramnios in which the pregnant mother does not produce enough amniotic fluid.
SymptomsThe front of the foot is bent inward. The back of the foot and the ankles are normal. (With a club foot, which is a different deformity, the foot will be pointed down and the ankle turned in.)
Signs and testsPhysical examination is all that is needed to diagnose metatarsus adductus.
TreatmentTreatment depends on the severity of the deformity. In most children, the problem corrects itself as normal use of the feet develops. Such cases do not need any treatment.
Stretching exercises may be needed when the problem does not go away with normal use of the foot. These are done if the foot can be easily moved into a normal position.
Rarely, this disease causes a rigid deformity that cannot be corrected with stretching exercises. In these cases, casting and even surgery may be needed. Other conditions may need to be considered in these children. A pediatric orthopaedic surgeon should be involved in treating more severe deformities.
Expectations (prognosis)The outcome is excellent. Nearly all patients eventually have a normal looking, fully functional foot.
ComplicationsDevelopmental dislocation of the hip may be associated with a small number of infants with metatarsus adductus.
Calling your health care providerCall your health care provider if you are concerned about the appearance or flexibility of your infant's feet.
Metatarsus adductus is a foot deformity. The bones in the front half of the foot bend or turn in toward the body.
Alternative NamesMetatarsus varus; Forefoot varus
Causes, incidence, and risk factorsMetatarsus adductus is thought to be caused by the infant's position inside the womb. Risks may include:
There may also be a family history of the condition.
Metatarsus adductus is a fairly common problem. It is one of the reasons why people develop "in-toeing."
Newborns with metatarsus adductus often have a problem called developmental dysplasia of the hip (DDH), in which the thigh bone slips out of the hip socket.
SymptomsThe front of the foot is bent or angled in toward the middle of the foot. The back of the foot and the ankles are normal. About half of children with metatarsus adductus have the problem in both feet.
(Club foot is a different deformity. The foot is pointed down and the ankle is turned in.)
Signs and testsPhysical examination is all that is needed to diagnose metatarsus adductus.
A careful exam of the hip should also be done to rule out other causes of metatarsal adductus.
TreatmentTreatment depends on how rigid the foot is when the doctor tries to straighten it.
If the foot is very flexible and easy to straighten or move in the other direction, no treatment may be needed. You child will be followed closely for a period of time.
In most children, the problem corrects itself as they use their feet normally. They don't need any further treatment.
If the problem does not improve or your child's foot is not flexible enough, other treatments will be tried:
Rarely, your child will need to have a cast on the foot and leg. Casts work best if they are put on before your child is 8 months old. The casts will probably be changed every 1 - 2 weeks.
Surgery may be needed, but not very often. Most of the time, your doctor will delay surgery until your child is between 4 and 6 years old.
A pediatric orthopaedic surgeon should be involved in treating more severe deformities.
Expectations (prognosis)The outcome is almost always excellent. Nearly all patients eventually have a normal looking and working foot.
ComplicationsA small number of infants with metatarsus adductus may have developmental dislocation of the hip.
Calling your health care providerCall your health care provider if you are concerned about the appearance or flexibility of your infant's feet.
ReferencesHosalkar HS, Spiegel DA, Davidson RS. The foot and toes. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 673.
Reviewed ByReview Date: 10/31/2010
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
What is Clubfoot? Clubfoot describes a group of foot abnormalities ,in which your baby's foot is twisted in. The tendons ( tissues connecting muscles to bone ) are shorter than usual. Clubfoot is the most common birth defect. 1:1,000 highest prevalence in Hawaiians and Maoris male:female ratio approximately 2:1 Anatomic location 50%of cases are bilateral Epidemiology Associated conditions arthrogryposis diastrophic dysplasia myelodysplasia tibial hemimelia amniotic band syndrome (Streeter dysplasia) upper extremity and hand anomalies common in this population Pierre Robin syndrome Opitz syndrome Larsen syndrome prune-belly syndrome anterior tibial artery hypoplasia or absence is common, regardless of etiology of clubfoot Anatomy of Clubfoot? Muscle contractures contribute to the characteristic deformity that includes (CAVE) Cavus (tight intrinsics, FHL, FDL) Adductus of forefoot (tight tibialis posterior) Varus (tight tendoachilles, tibialis posterior, tibialis anterior) Equinus (tight tendoachilles) Bony deformity consists of medial spin of the midfoot and forefoot relative to the hindfoot talar neck is medially and plantarly deviated calcaneus is in varus and rotated medially around talus navicular and cuboid are displaced medially Are Club Feet genetic? strongly suggested unaffected parents with affected child have 2.5% - 6.5% chance of having another child with a clubfoot familial occurrence in 25% link to PITX1 How are Clubfeet diagnosed? Ultrasound 1st trimester associated anomalies, including non-musculoskeletal 2nd trimester true clubfeet 3rd trimester false positive rate is higher due to intrauterine crowding Radiographs often not taken recommended views, if taken(dorsiflexion lateral (Turco view) AND AP Treatment of Clubfeet? Ponseti method. Gentle stretching and casting to gradually correct the deformity. Treatment begins shortly after birth 6-8 weekly plasters needed Achilles tenotomy. 90 percent of babies will require a minor procedure to release continued tightness in the Achilles tendon (heel cord), managed by Tendo Achilles Tenotomy i.e the tendon is cut. Plaster is then applied for 3 weeks. Bracing. The brace keeps the foot at the proper angle to maintain the correction. This bracing program can be demanding for parents and families, but is essential to prevent relapses. For More Details, Please Contact Dr Gaurav Jain 20 B Sainath Colony , Indore Call us +919111464959 Visit our website
What is Clubfoot? Clubfoot describes a group of foot abnormalities ,in which your baby's foot is twisted in. The tendons ( tissues connecting muscles to bone ) are shorter than usual. Clubfoot is the most common birth defect. 1:1,000 highest prevalence in Hawaiians and Maoris male:female ratio approximately 2:1 Anatomic location 50%of cases are bilateral Epidemiology Associated conditions arthrogryposis diastrophic dysplasia myelodysplasia tibial hemimelia amniotic band syndrome (Streeter dysplasia) upper extremity and hand anomalies common in this population Pierre Robin syndrome Opitz syndrome Larsen syndrome prune-belly syndrome anterior tibial artery hypoplasia or absence is common, regardless of etiology of clubfoot Anatomy of Clubfoot? Muscle contractures contribute to the characteristic deformity that includes (CAVE) Cavus (tight intrinsics, FHL, FDL) Adductus of forefoot (tight tibialis posterior) Varus (tight tendoachilles, tibialis posterior, tibialis anterior) Equinus (tight tendoachilles) Bony deformity consists of medial spin of the midfoot and forefoot relative to the hindfoot talar neck is medially and plantarly deviated calcaneus is in varus and rotated medially around talus navicular and cuboid are displaced medially Are Club Feet genetic? strongly suggested unaffected parents with affected child have 2.5% - 6.5% chance of having another child with a clubfoot familial occurrence in 25% link to PITX1 How are Clubfeet diagnosed? Ultrasound 1st trimester associated anomalies, including non-musculoskeletal 2nd trimester true clubfeet 3rd trimester false positive rate is higher due to intrauterine crowding Radiographs often not taken recommended views, if taken(dorsiflexion lateral (Turco view) AND AP CTEV (CLUB FOOT) treatment in Indore , Bhopal , Ujjain , Dewas , Guna Treatment of Clubfeet? Ponseti method. Gentle stretching and casting to gradually correct the deformity. Treatment begins shortly after birth 6-8 weekly plasters needed Achilles tenotomy. 90 percent of babies will require a minor procedure to release continued tightness in the Achilles tendon (heel cord), managed by Tendo Achilles Tenotomy i.e the tendon is cut. Plaster is then applied for 3 weeks. Bracing. The brace keeps the foot at the proper angle to maintain the correction. This bracing program can be demanding for parents and families, but is essential to prevent relapses. For More Details, Please Contact Dr Gaurav Jain 20 B Sainath Colony , Indore Call us +919111464959 Visit our website