Pediatrics in Review Note to Institutions for Site Subscriptions
HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Rapid Responses: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Rapid Responses are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Craig, C. L.
Right arrow Articles by Goldberg, M. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Craig, C. L.
Right arrow Articles by Goldberg, M. J.

Foot and Leg Problems

Clifford L. Craig MD1
Michael J. Goldberg MD1
 1 Department of Orthopaedics, New England Medical Center, Boston, MA

Metatarsus Adductus

Forefoot adduction, a common deformity in infants, can present a spectrum of severity. Unfortunately, the terminology used in the literature is confusing. Congenital metatarsus adductus is an intrauterine postural deformity of the forefoot. Congenital metatarsus varus is an intrauterine subluxation of the tarsometatarsal joint, with adduction of the metatarsals. The distinction is important because metatarsus adductus usually corrects spontaneously, whereas metatarsus varus will progress without active intervention.

INCIDENCE AND ETIOLOGY

Metatarsus varus occurs in about 1 per 1000 live births. There is no definable inheritance pattern. The risk of a second occurrence within a family is about 1 in 20. Pathogenesis has been studied by dissecting the feet of stillborn infants. This supports the concept of medial subluxation of the tarsometatarsal joints occurring while the foot is dorsiflexed. Adaptive changes of the bone and soft tissues occur secondarily. The incidence of congenital metatarsus adductus is unknown but is far more frequent than 1 per 1000 live births. The etiology is presumed to be a "packaging problem," with the forefoot compressed into adduction. Greater utilization and expertise with fetal ultrasound will help resolve these issues.

DIAGNOSIS

In congenital metatarsus adductus, the forefoot easily can be corrected passively to line up parallel to the heel and frequently can be overcorrected into abduction.






HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
Pediatrics Pediatrics in Review
Copyright © 1993 by the American Academy of Pediatrics.