METADDUCTUS
By: Robert H. Sheinberg, D.P.M., D.A.B.F.A.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 x-ray image of Metarsus Adductus where the long bones of the foot, the metatarsals. that correlate to each toe are diverted at the level of the midfoot inward leading to a C-shaped foot.
Pics Below of Serial Casting for a Cavovarus foot that is reducible in a 5 week old.
