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Johns Hopkins Pediatric Orthopaedics Patient Guide to Metatarsus Adductus
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Our Pediatric Orthopaedic Physicians
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What is Metatarsus Adductus?
The metatarsal bones are located in the middle part of the foot. "Adduct" means "to move towards the middle of the body." "Metatarsus adductus," then, refers to the metatarsal bones of the foot being turned towards the middle of the body. This developmental disorder is the most common foot condition seen by those caring for children.
What are the signs and symptoms of metatarsus adductus?
A parent may notice that his or her child's foot does not appear normal. The front part of the foot (called the "forefoot") points inwardly and may be turned slightly under compared to the normal side. The inside of the foot takes on an unusual concave curve while the outside of the foot takes on a convex curve. Unlike clubfoot (see Patient Guide to Clubfoot) there is no foot drop.
The physician can assess the degree of metatarsus adductus by testing the range of motion of the foot. The forefoot is deviated, but tends to be flexible. The hindfoot (near the heel) is normal.
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What causes metatarsus adductus?
The cause is unknown. No correlation of metatarsus adductus with gestational age at birth, maternal age at birth, or birth order has been found. One theory is that the condition results from the fetus being tightly packed inside the uterus during development. This might result in holding the foot in an abnormal posture that could lead to deformity.
What is the treatment?
The condition goes away by itself in the majority of children. It is important to make parents aware of this and otherwise educate them about the deformity. Treatment with casts or special shoes is occasionally needed.
Surgery is rarely performed and done so only in children over four years of age with a significant amount of abnormality. There are various procedures currently available. All of them reshape the foot by intentionally cutting certain bones ("osteotomy") and then fixing them in a position to return the foot to the normal shape.
What is the prognosis of metatarsus adductus?
The flexible deformity tends to persist until one or two years of age. The majority of feet (86%), however, become normal. Some feet (10%) stay moderately deformed. The remaining 4% continue to be stiff and quite deformed even after treatment.
If there are any concern, please seek medical monitoring by your pediatric orthopaedist.
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Link to AAOS - InToeing
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