Metatarsus adductus

Metatarsus adductus is a common congenital foot deformity seen in infants and young children. It is characterized by the inward deviation of the forefoot relative to the hindfoot, giving the foot a curved or “C-shaped” appearance when viewed from above. Unlike clubfoot, which involves multiple deformities including ankle and heel involvement, metatarsus adductus primarily affects the alignment of the metatarsal bones. The heel usually remains in a neutral position, which helps distinguish this condition from more complex foot deformities.

The exact cause of metatarsus adductus is not fully understood, but it is thought to be related to intrauterine positioning. In particular, compression of the developing fetus inside the uterus may contribute to abnormal foot alignment. Risk factors include multiple births, oligohydramnios (low amniotic fluid), or a family history of foot deformities. The condition is often noticed at birth or within the first few months of life and can vary in severity from flexible and mild to rigid and more pronounced.

Diagnosis is usually made through a physical examination. The healthcare provider will assess the flexibility of the foot, noting whether the forefoot can be passively straightened to a neutral position. In mild and flexible cases, the deformity often resolves spontaneously as the child grows and begins to bear weight. Radiographic imaging is rarely necessary unless the deformity is severe or does not improve over time. The key diagnostic feature remains the medial deviation of the metatarsals with a normal hindfoot.

Treatment depends on the severity and flexibility of the condition. Mild cases may resolve without intervention, though stretching exercises and parental guidance on positioning are often recommended. Moderate cases may benefit from splinting, bracing, or special shoes. For severe or rigid deformities that persist beyond infancy, serial casting or orthopedic referral may be required. Fortunately, most children with metatarsus adductus respond well to conservative management, and long-term complications are uncommon if addressed early..

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