Metatarsus Adductus (Metatarsus Varus)

GENESIS

Compression of the forefoot with the legs flexed across the lower body in late gestation is a frequent cause of metatarsus adductus (also known as metatarsus varus ), which occurs in about 1.2 per 1000 live births and has an 80% predilection for males. Metatarsus adductus is associated with congenital hip dislocation in 5–10% of infants, further implicating fetal constraint as an important etiologic factor. In a large group of children treated for idiopathic early-onset scoliosis, there was a high prevalence of commonly associated deformational conditions such as hip dysplasia, torticollis, plagiocephaly, metatarsus adductus, and clubfoot. Such fetal constraint takes place late in gestation, and metatarsus adductus is rarely found in premature infants delivered before 30 weeks of gestation. Metatarsus adductus is the most common pediatric foot deformation related to intrauterine constraint. Although most cases may resolve spontaneously, moderate and severe cases may cause future discomfort and are therefore often treated. Common treatment alternatives include stretching, serial casting, and orthoses. Surgery is reserved for severe cases that are unresponsive to conservative management.