For kids with metatarsus adductus, treatment depends on the severity of their condition. Our pediatric orthopedic specialists are experts in the diagnosis of metatarsus adductus. In most cases, kids outgrow the conditions. In others, physical therapy and exercises can help. In rare cases, surgery may be required. Fortunately, we have extensive experience in the care of kids with this condition and helping them to achieve their fullest potential.
Metatarsus adductus is a foot deformity. The bones in the front half of the foot bend or turn in toward the side of the big toe. The foot may be flexible, meaning it can be straightened by hand, or nonflexible, meaning it can't be straightened by hand.
Newborns with metatarsus adductus may also have a problem called developmental dysplasia of the hip (DDH). This allows the thigh bone slips out of the hip socket.
Metatarsus adductus is a fairly common problem. It is one of the reasons children develop "in-toeing."
The cause of metatarsus adductus is not known. It's thought to be caused by the infant's position inside the womb. Risks may include:
- The baby's bottom was pointed down in the womb (breech position).
- The mother had a condition called oligohydramnios, in which she did not produce enough amniotic fluid.
There may also be a family history of the condition.
Metatarsus adductus occurs in about 1 to 2 babies per 1,000 live births. It's more common in first born babies. If there's a family history of metatarsus adductus, there's a higher risk of your child being born with this condition.
The 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 one half of children with metatarsus adductus have these changes in both feet.
(Club foot is a different problem. The foot is pointed down and the ankle is turned in.)
The doctor makes the diagnosis based on a physical exam. The doctor will also ask about your child's. birth history and any family history of metatarsus adductus. A careful exam of the hip should also be done to rule out other causes of the problem.
In cases of nonflexible metatarsus adductus X-rays may be taken of your child's feet.
Treatment is rarely needed for metatarsus adductus. In most children, the problem corrects itself as they use their feet normally.
In cases where treatment is being considered, the determination will depend on how rigid the foot is when the health care provider 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. The child will be checked regularly.
In-toeing does not interfere with the child becoming an athlete later in life. In fact, many sprinters and athletes have in-toeing.
If the problem does not improve or your child's foot is not flexible enough, other treatments will be tried:
- Stretching exercises may be needed. These are done if the foot can be easily moved into a normal position. The family will be taught how to do these exercises at home.
- Your child may need to wear a splint or special shoes, called reverse-last shoes, for most of the day. These shoes hold the foot in the correct position.
In rare cases, 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 to 2 weeks.
Surgery is rarely needed. Most of the time, your provider will delay surgery until your child is between 4 and 6 years old.
A pediatric orthopedic surgeon should be involved in treating more severe deformities.
The outcome is almost always excellent. Most of the time metatarsus adductus resolves itself and almost all children will have a foot that works.