Metatarsus Adductus

What is metatarsus adductus?

Metatarsus adductus is a foot condition that involves a baby/child’s foot being curved inwards.  This foot position is thought to be related to the position of the baby within the mother’s uterus during pregnancy and is usually noted soon after birth. It may affect one or both feet.

What is the natural history?

Most babies with metatarsus adductus have flexible feet and their foot position can be easily corrected. In this instance the condition resolves without any treatment over the first few months to few years of life.

In some cases, the baby’s foot is stiff and is not easily corrected. In this instance treatments such as gentle stretches, plaster casts, special braces and shoe inserts may be required. Assessment and monitoring by your baby’s doctor, child health nurse or physiotherapist will be required.

What conditions are associated with it?

Babies who have metatarsus adducts will require careful examination of their hips and in some cases may require a screening hip ultrasound. This is to assess for potential developmental dysplasia of the hips which is associated with metatarsal adducts in 15-20% of cases. Metatarsus adducts is also associated with torticollis (tightness in a baby’s neck muscles).

Who gets it?

Metatarsus adductus occurs in approximately 1 in 1,000 births and affects boys and girls equally. It affects both feet in approximately 50 percent of cases. It is more likely to occur in late pregnancies, first pregnancies, twin pregnancies and any condition which reduces intrauterine volume such as oligohydraminos.

What tests are needed?

Imaging is not usually required to diagnose a foot with metatarsus adducts. It is diagnosed from a thorough clinical examination of the child’s feet.

How is is treated?

Babies who have flexible feet may not require any treatment and the condition will resolve without active treatment over the first few months to years of life.

Babies who have a stiff foot may require active treatment to help the foot position to correct.

Gentle exercises to correct the foot position should be performed regularly (such as every nappy change) when your baby is relaxed, fed and warm. They should never cause discomfort or be painful. Your baby’s doctor, child health nurse or physiotherapist will show you how to do these exercises.

Exercise 1. Gently move the front of your baby’s foot outwards so that the outside border of the foot is straight. Hold this position for a few seconds or longer if your baby is comfortable. 

Exercise 2. Gently stroke the outer aspect of your baby’s foot and lower leg to encourage your baby to move their foot into a straight position.

Plaster casts 

If the baby has a very rigid foot that does not respond to gentle stretches, a series of plaster casts may be used to correct the position of the baby’s foot.

Bebax boots 

A bebax boot may be used if your baby’s foot is  stiff and does not respond to gentle stretches. A bebax boot is an orthotic device that involves a close-fitting leather boot with a hinge that connects the back of the boot to the front of the boot. This hinge can be adjusted to gradually correct the position of your baby’s foot. 

Shoe inserts

A shoe insert may be used inside the shoe of an older child to maintain your child’s foot position and prevent it from curving in as your child grow.