What can be done for a metatarsus adductus in a child?
Posted: Jul 23, 2022
Metatarsus adductus is a foot deformity that is present at birth and can give the parents some concern. It is a deformity where the forefoot is angled inward on the rearfoot. The deformity only affects the forefoot and midfoot. It does not affect the rearfoot. The cause of a metatarsus adductus is not known. There are a number of theories or ideas that do have some support and could possibly explain why some babies are born with it and some are not. It could be as something as simple as the position that the foot is in the uterus and that puts pressure on the foot to change the angle of the forefoot. The other main theory is that it is a very mild form of a clubfoot. Early on in development the foot is pointed down and inwards. As the fetus develops towards birth, the foot moves to the normal position the foot should be in. If it does not do that, then that is a clubfoot. It is possible that a metatarsus adductus is that the foot has not got its full way in its development to be in a normal position at birth. While most of the foot has developed a normal alignment, the forefoot hasn’t. The reason for this occurring during the pregnancy is not known. It could be an exposure to some sort of factor during the pregnancy such as drinking alcohol.
If a baby is born with a metatarsus adductus, then the sooner that treatment is started, the better. The bones are more able to be molded if the child is younger. The mildest cases probably do not need treating. The more severe and rigid ones will need to be treated. Often the mild ones are not detected at birth and become more apparent later when the child begins to walk. Typically, at birth it is manipulated and stretched and the placed in a plaster cast to hold it in the corrected position. A week or so later, this process is again repeated. This is done over a number of months until the deformity is corrected. If it is not detected until later or if the decision is made to wait until the child is older before treating it, there is an option to use special kinds of foot orthotics the put pressure on the forefoot to change its angle as it continues to grow. These kinds of foot supports are relatively benign and may need to be used for a year or so. You can often see some really bad advice to just put the shoes on the wrong foot and this can help force the forefoot back into a more correct position. It does not work, so don’t follow that advice. If all these approaches do not help, then there are surgical options to correct the alignment of the foot. If it is minor, then the child can cope with this and it is not likely to be any problem. If the metatarsus adductus is more serious, then the surgery is probably worth it.
Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.