Metadductus

METADDUCTUS
By:  Robert H. Sheinberg, D.P.M., D.A.B.P.S., F.A.C.F.A.S.

CONDITION:

  • A deformity of the front part of the foot in which all of the metatarsals are positioned to the inside of the foot.

CAUSE:

  • Intrauterine position.
  • Hereditary predisposition.
  • Hyperactive muscle (tibialis anterior, tibialis posterior muscle or abductor hallucis).
  • Abnormal bone or joint structure.

SIGNS AND SYMPTOMS:

  • The front half of the foot is turned in relative to the back half of the foot.
  • Foot may turn up and in, causing a crease of skin on the inner arch.
  • Foot is shaped like a “C” when viewing it from the sole.
  • May be associated with rotational problems of the lower leg (internal tibial torsion).
  • Excessive space between the first and second toes.
  • Prominent bone (fifth metatarsal) on the outside of the foot.
  • May be associated with the curvature to the heel bone (calcaneal varus).

ASSOCIATED PROBLEMS:

  • Juvenile bunion and hammertoe deformities.
  • Lateral drifting of all the digits as the tendons on the top of the foot pull the toes to the outside.
  • Stress fractures to the outside bones in teenagers and adults.
  • Arthritis in adults due to the abnormal joint positions.

TREATMENT:

  • Identify the level of the problem (foot, ankle or leg) and the foot’s flexibility.
  • Identify any muscle hyperactivity.
  • Corrective shoes and occasionally night splinting.
  • Casting of the foot and leg to straighten the position of the foot and in some cases the lower leg.
  •  Prognosis is excellent if the condition is treated early.

 


Below is an illustration of the bottom of the foot as it relates to the severity of metatarsus adductus with the line of progression throught the foot beginning at the posterior heel and exiting about the 2nd digit, then as the deformity worsens, the line exits further latera as the foot begins to take on a more c-shape appearance due to altered position of the metatarsal bones.