Understanding and Treating Metatarsus Adductus in Children

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Although, It is a relatively benign deformity that has been shown to produce minimal disability as an adult, children with metatarsus adductus may require surgical correction.Mild and moderate forms of metatarsus adductus tend to resolve spontaneously by 3 years of age. Children with types mild and moderate metatarsus adductus need only observation; occasionally, a corrective shoe or commercial orthosis can hasten correction.(13)

The severe deformity is best managed by manipulation and serial casting. For best results, this should be performed before an infant reaches 8 months of age. The forefoot is manipulated into the correct position while the hindfoot is supported in the neutral position and a short leg cast is applied. The cast is changed at 1- to 2-week intervals until complete correction has been achieved. Most feet will correct in 6 to 8 weeks. After casting, the foot is maintained in a corrective shoe or an orthosis until the child is walking well.(1,11)In this study, all feet had received a trial of repeated manipulation and casting before the tenotomy procedure but it failed, this was attributed to the older age of patients at the start of manipulation.
Some outhers recommended that, if a significant forefoot adduction is present in a child up to 6 years of …show more content…

Mitchell (1980) reported that; in true congenital metatarsus adductus there is a contraction or shortening of the abductor hallucis muscle and tendon which is considered to be the primary deforming factor.In the early severe or resistant deformity correction can be achieved by either division of the tendon with release of its capsular attachment, or, in the more severe deformity, by complete release of the abductor hallucis muscle from its extensive attachment to bone and soft tissues.(16) Lichtblau S (1975) also recommended Sectioning of the abductor hallucis tendon for early correction of the metatarsus adductus deformity especially in the residual of a treated equinovarus

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