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Metatarsus Adductus

more about Metatarsus Adductus

  • Since most of the cases are infants, this will be discussed by referring to infants.
  • This is a condition in which the front part of the foot (the area adjacent to the toes) is slanted toward the midline of the body, but the midfoot and rear of the foot are pointing straight ahead.  Usually, it is divided into two categories:
    1. There can be an angling of the front of the foot that is fixed (because the bones are slanted toward the midline).
    2. The alignment can be straightened easily by pulling on the front part of the foot (because the bones themselves are not fixed in a slanted angle in their attachment to the midfoot).
  • Each toe is attached to its own metatarsal bone in the front of the foot.  The 5 metatarsal bones run lengthwise in the front part of the foot.  The end part of each metatarsal bone connects to its matching toe.  The beginning edge of each metatarsal bone attaches to the midfoot at a joint of another bone.
  • This condition definitely involves a slanting inward of the 1st metatarsal bone, where it meets a bone called the tarsal bone, at a joint.  Other metatarsal bones may or may not appear to be slanted inward.
  • The condition often involves both the right and left foot of the affected infant.

  • None

  • The position of the fetus in the uterus probably cramps the foot in the case of metatarsus adductus.  After remaining in this position, the foot of the fetus is more or less fixed in this position.

  • Examining the front of the foot, the great toe (and perhaps some of the other toes) is slanting inward (angled toward the midline of the body), while the foot in general is pointing straight ahead.
  • On X-ray of the affected foot, the 1st metatarsal bone (the bone attached to the great toe) is definitely slanting toward the midline of the body (slanted inward), while the metatarsals in general are often pointing straight ahead.  One can see that the point where this abnormal angle occurs is at the joint where the 1st metatarsal meets the tarsal bone.  In an X-ray of a completely normal foot, the 5 metatarsal bones would lie parallel, looking like railroad tracks side-by-side.
  • Usually X-rays are not necessary in this condition, because the appearance of the front of the foot is so obvious.
  • On examination, the side of the foot following along the length of the great toe is curved toward the midline of the body, instead of pointing straight ahead.  Usually there is an abnormally wide space between the great toe and the second toe, because the 1st metatarsal is the only slanted bone (and it is attached to the great toe).  The rest of the foot and the ankle are normal, because the deformity is at a metatarsal joint.
  • Examining the infant, trying to passively move the foot into a straight-ahead position will either be successful, or (if the deformity is fixed at the joint) will not be successful.

  • Firstborn children are more likely to have this condition.

  • Metatarsus adductus usually requires no treatment, since it is a normal occurrence and usually disappears, as the child starts standing and walking.
  • If the condition is very noticeable and the front of the foot can be straightened into the neutral position (with all toes pointing straight ahead) just by passively moving the infant's foot, then special shoes that keep the foot in a neutral position can be used.  Usually, this is successful.
  • If further correction is desired, or there is actually a deformity where the slanted angle of the 1st metatarsal is "fixed" at its junction with the tarsus, a series of casts can be used, rather than continuing corrective shoes.

  • A severe case might require more casting or even an operation to straighten the metatarsal at its junction with the middle part of the foot.  This usually would not be operated upon until a number of years have passed, to allow for natural correction.

  • Consult a physician if the front part of the foot, and the great toe, slant inward, or if each great toe seems to be pointing at the other great toe.

  • Metatarsus varus is a similar condition, in which the front of the foot has a slight rotation or twist to it, in addition to the slant toward the midline of the body.

more about Metatarsus Adductus

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