Metatarsus Adductus is a problem in children (and occasionally adults) in which the forefoot is excessively adducted on the rearfoot

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Metatarsus Adductus (MTA) is a common congenital foot deformity where the forefoot is adducted, or curved inward, relative to the hindfoot. It usually presents at birth or within the first few months of life. The condition affects the metatarsal bones, which are the long bones in the foot leading to the toes, causing them to angle medially. While the heel remains in a normal position, the forefoot appears curved like a “C-shape” when viewed from the bottom. It’s considered one of the most frequent foot abnormalities in infants, with a higher prevalence in first-born children and those with a family history of foot deformities.

The cause of Metatarsus Adductus isn’t entirely clear, but it’s believed to result from intrauterine positioning—essentially, the baby’s foot being pressed into an abnormal shape due to space constraints in the womb. This explains why it’s often bilateral and more noticeable in full-term infants. There are two main types: flexible, where the foot can be manually straightened, and rigid, where the deformity is more fixed and less responsive to gentle manipulation. A flexible MTA usually resolves on its own, while rigid forms may need intervention.

Diagnosis of MTA is typically clinical and based on physical examination. The “V-finger test” is a quick, informal method where the examiner uses their index and middle fingers to assess the curvature of the forefoot. X-rays are rarely needed unless the diagnosis is unclear or the deformity is rigid and persistent. It’s crucial to distinguish MTA from more serious conditions like clubfoot (talipes equinovarus), which involves multiple planes of foot deformity and generally requires more aggressive treatment.

Management of Metatarsus Adductus depends on the severity and flexibility of the deformity. Most mild and moderate flexible cases resolve spontaneously by 6 to 12 months of age without any treatment. For persistent or more severe cases, especially rigid ones, options include stretching exercises, serial casting, or orthotic bracing. Surgery is rarely needed and typically reserved for older children with significant residual deformity that impairs function. Early identification and monitoring are key to ensuring that the condition does not interfere with the child’s walking or foot development.

Most Useful Resources:
Metatarsus Adductus (Podiatry Arena)
Metatarsus Adductus (PodiaPaedia)
Metatarsus Adductus (Foot Health Forum)
Metatarsus Adductus (Podiatry ABC)

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