Metatarsus adductus is a foot deformity. The bones in the front half of the foot bend or turn in toward the side of the big toe.
Metatarsus varus; Forefoot varus; In-toeing
Metatarsus adductus is thought to be caused by the infant's position inside the womb. Risks may include:
There may also be a family history of the condition.
Metatarsus adductus is a fairly common problem. It is one of the reasons why people develop "in-toeing."
Newborns with metatarsus adductus may also have a problem called developmental dysplasia of the hip (DDH), which allows the thigh bone to slip out of the hip socket.
The front of the foot is bent or angled in toward the middle of the foot. The back of the foot and the ankles are normal. About one half of children with metatarsus adductus have these changes in both feet.
(Club foot is a different problem. The foot is pointed down and the ankle is turned in.)
Treatment is rarely needed for metatarsus adductus. In most children, the problem corrects itself as they use their feet normally.
In cases where treatment is being considered, the decision will depend on how rigid the foot is when the health care provider tries to straighten it. If the foot is very flexible and easy to straighten or move in the other direction, no treatment may be needed. The child will be checked regularly.
In-toeing does not interfere with the child becoming an athlete later in life. In fact, many sprinters and athletes have in-toeing.
If the problem does not improve or your child's foot is not flexible enough, other treatments will be tried:
Rarely, your child will need to have a cast on the foot and leg. Casts work best if they are put on before your child is 8 months old. The casts will probably be changed every 1 to 2 weeks.
Surgery is rarely needed. Most of the time, your provider will delay surgery until your child is between 4 and 6 years old.
A pediatric orthopedic physician should be involved in treating more severe deformities.
The outcome is almost always excellent. Almost all children will have a foot that works.
A small number of infants with metatarsus adductus may have developmental dislocation of the hip.
Call your provider if you are concerned about the appearance or flexibility of your infant's feet.
Deeney VF, Arnold J. Orthopedics. In: Zitelli BJ, McIntire SC, Nowalk AJ, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 22.
Kelly DM. Congenital anomalies of the lower extremity. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 29.
Winell JJ, Davidson RS. The foot and toes. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 694.
There are no recent clinical trials available for this condition. Please check back because new trials are being conducted frequently.