East Coast Podiatry
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Last Updated: 24 Jun 2020

Metatarsus Adductus

Metatarsus Adductus is a common foot deformity affecting around 1 to 2 children in around 1000 births. In such cases, the bones in the middle of the foot, the metatarsals, curve inwards, causing the front part of a child’s foot to be turned inward in relation to the rear foot. Children diagnosed with the condition frequently have a visible deformity where the front part of the foot faces inward and it is common for both feet to be affected. This can be of great concern to parents, but there are non-invasive, painless treatment options available for correcting the deformity.

Signs and symptoms

During the early stages of your child’s development or at birth, you or your physician may notice that your child’s foot has a curved shape. In more obvious cases, the forefoot may be rotated inward and pointing towards the midline of the body, and the outside of the foot may also appear to be rounded. While ‘club foot’ may appear visually similar to metatarsus adductus, there is no foot drop present for the latter.

This deformity may or may not cause pain to your child initially, however, altered alignment of the forefoot for any prolonged period may put increased stress on other joints of the body, leading to conditions such as the early onset of osteoarthritis in the damaged joints.

ECP | Children Feet

Causes & Diagnosis

The exact cause of metatarsus adductus is unclear, however recent research has supported the theory that condition is caused by the infant’s position while in the womb. Babies with less amniotic fluids or those in the breech position (bottom pointing down) appear to be at an increased risk of being born with metatarsus adductus. Having a family history of the metatarsus adductus is also one of the possible risk factors for a child to develop the condition.

It is important to seek professional advice if you suspect that your child may have metatarsus adductus. While some cases resolve themselves over time, others have long-lasting effects that can affect the mobility of your child. To avoid this, a podiatrist will conduct a comprehensive history-taking as well as a physical examination. The use of specialist imaging equipment such as X-rays or MRIs may be required to assess the extent and severity of the condition.

ECP | Dislocated Thigh Bone Skeleton

Treatment options

The importance of early intervention should be stressed for conditions such as metatarsus adductus. If metatarsus adductus is observed at birth, a specialised serial casting can be applied for optimal results. Metatarsus adductus can be easily corrected at a young age but becomes harder to treat as the child matures and their skeleton matures and hardens.

In some cases, metatarsus adductus will resolve over time without intervention, however, this is dependent on the severity of the deformity and when it is identified. If the child is already walking by the time the condition is identified, the use of custom foot orthosis may be required long-term to help support the foot, allowing a more natural alignment of the foot to develop. This distributes the body’s weight correctly across the foot, avoiding overloading and damaging the small joints of the foot.

The nature of this condition highlights the importance of a thorough musculoskeletal assessment, as this provides the healthcare professional an opportunity to examine the patient in detail and ensure that any intervention that is required can be implemented at an early stage to achieve a positive treatment outcome.

Research conducted in 2015 found that metatarsus adductus can be a risk factor for developing symptomatic hallux valgus deformity (bunion) in later life.1 Therefore, it is important to seek advice from a podiatrist who can accurately advise you on the best course of treatment for your child.

Babies with metatarsus adductus may also be at an increased risk of developmental dysplasia of the hip (DDH). This condition occurs when the top of the thigh (femur) slips in and out of the hip socket, resulting in a dislocation of the joint.

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