Presentation
Rigid: Presents with medial subluxation of the tarsometatarsal joints. There is valgus of the hindfoot and the navicular is later to the head of the talus. [physio-pedia.com]
Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 15-18, 2015; Long Beach, Calif. Disclosure: Aiyer reports no relevant financial disclosures. [healio.com]
Sadly and incorrectly, surgeons often feel that if a deformity is present, then they should perform surgery. Dr. Jay is a Professor of Foot and Ankle Orthopedics at Temple University. [podiatrytoday.com]
The purist would differentiate between the two by stating that in the metatarsus adductus there is no supination of the forefoot and that in the varus deformity, supination is present. [btb.termiumplus.gc.ca]
Treatment
Abstract There are various treatment approaches for the subjects with metatarsus adductus, including nonsurgical and surgical treatment. [pubmed.ncbi.nlm.nih.gov]
If treatment is needed, it depends on how easily the affected foot bends. The goal of treatment is to straighten the position of the forefoot and heel. Treatment may include: Observation. [stanfordchildrens.org]
In the few children who require treatment, the treatment is usually successful. [choc.org]
treatment) in the majority of affected children. [chop.edu]
Nonoperative Treatment Flexible deformities that can actively be corrected to midline No treatment required Flexible deformities that can passively be corrected to midline Serial stretching by parents at home Rigid deformity with medial crease Serial [orthobullets.com]
Prognosis
What is the prognosis for an infant with metatarsus adductus? Flexible metatarsus adductus tends to persist until 1 – 2 years of age. In the majority of cases, the foot goes back to normal. [hopkinsmedicine.org]
Outlook (Prognosis) The outcome is almost always excellent. Almost all children will have a foot that works. Possible Complications A small number of infants with metatarsus adductus may have developmental dislocation of the hip. [mountsinai.org]
Regardless of how much the forefoot turns inward, starting treatment immediately after birth improves your child's prognosis. [childrenshospital.org]
[…] accepted and observed technique calcaneal osteotomy for hindfoot valgus possible midfoot osteotomies to correct midfoot and forefoot deformities multiple metatarsal osteotomies with forefoot pinning and tarsometatarsal capsular release (Hamen procedure) Prognosis [orthobullets.com]
[…] extent of the condition Tolerance for the specific procedure Expectations for the condition Interventions include:[edit | edit source] Passive Stretching Passive Manipulation exercises Stretching Serial Casting Footwear Surgery to release the joints Prognosis [physio-pedia.com]
Etiology
Left foot affected more frequently than right More common in males Etiology and Pathophysiology Etiology of MA is not yet fully understood; most commonly attributed to increased intrauterine pressure, supported by increased incidence in twin gestation [unboundmedicine.com]
[…] occurs in approximately 1 in 1,000 births equal frequency in males and females bilateral approximately 50% of cases Increased incidence in late pregnancy first pregnancies twin pregnancies oligohydramnios Associated conditions DDH (15-20%) torticollis Etiology [orthobullets.com]
Epidemiology and Etiology[edit | edit source] There is an incidence of 1 in 100 to 1 in 5,000 live births.[7] The cause of metatarsus adductus remains unknown. It is however, thought to be related to intrauterine compression. [physio-pedia.com]
The etiology of metatarsus adductus is not fully understood at this point but there are a few theories. [podiatrytoday.com]
Juvenile hallux valgus: etiology and treatment. Foot Ankle Int 1995;16:682–697. [doi: 10.1177/107110079501601104] Martinelli N, Marinozzi A, Cancilleri F, Denaro V. [synapse.koreamed.org]
Epidemiology
Epidemiology Incidence MA occurs in 1 to 2 children per 1,000 live births. [unboundmedicine.com]
Definition Metatarsus varus - adduction of the forefoot at the TMTJ Intrauterine positional deformity / packaging defect Epidemiology 1:1000 - M = F - bilateral in 50% - 10% have CDH Aetiology Unclear Theories - intrauterine positioning defect - prone [52.62.202.235]
Epidemiology Incidence occurs in approximately 1 in 1,000 births equal frequency in males and females bilateral approximately 50% of cases Increased incidence in late pregnancy first pregnancies twin pregnancies oligohydramnios Associated conditions DDH [orthobullets.com]
Epidemiology and Etiology[edit | edit source] There is an incidence of 1 in 100 to 1 in 5,000 live births.[7] The cause of metatarsus adductus remains unknown. It is however, thought to be related to intrauterine compression. [physio-pedia.com]
Epidemiology Most common congenital foot deformity : 1-2 per 1000 live births More common in female infants Left-side more commonly affected than right III. Cause In-utero confinement IV. [tripdatabase.com]
Pathophysiology
Left foot affected more frequently than right More common in males Etiology and Pathophysiology Etiology of MA is not yet fully understood; most commonly attributed to increased intrauterine pressure, supported by increased incidence in twin gestation [unboundmedicine.com]
Pathophysiology Affects Lisfranc Joint Adduction of s with foot inversion Results in V. [tripdatabase.com]
Prevention
Genetics No known genetic link in most cases of MA One case study of MA in brothers with Aarskog-Scott syndrome Higher incidence if sibling has MA Risk Factors First pregnancy Twin gestation Oligohydramnios General Prevention No known preventative measures [unboundmedicine.com]
Preventive health Disease prevention and early detection targeting specific areas such as obesity, physical activity, sexual health and heart disease. Radiation The department administers the Radiation Act 2005. [www2.health.vic.gov.au]
Never blow warm or hot air into the cast Do not put powders or lotion inside the cast Cover the cast while your child is eating to prevent food spills and crumbs from entering the cast Prevent small toys or objects from being put inside the cast Elevate [childrenswi.org]
Cover the cast while your child is eating to prevent food spills and crumbs from entering the cast. Prevent small toys or objects from being put inside the cast. Elevate the cast above the level of the heart to decrease swelling. [bartonhealth.org]