Metatarsus adductus

Specific treatment for metatarsus adductus will be determined by your child's physician based on

• your child's age, overall health, and medical history
• the extent of the condition
• your child's tolerance for specific procedures, or therapies
• expectations for the course of the condition
• your opinion or preference.

The goal of treatment is to straighten the position of the forefoot and heel. Treatment options vary for infants, and may include

• observation, for those with a supple, or flexible, forefoot
• stretching or passive manipulation exercises casts
• surgery.

Studies have shown that metatarsus adductus may resolve without treatment in the majority of affected children.

• Your child's physician or nurse may instruct you on how to perform passive manipulation exercises on your child's feet during diaper changes.
• A change in sleeping positions may also be recommended. Suggestions may include side-lying positioning.

In rare instances, the foot does not respond to the stretching program, plaster casts may be applied.

• Casts are used to help stretch the soft tissues of the forefoot.
• The plaster casts are changed every one to two weeks by your child's pediatric orthopedist.
• If the foot responds to casting, straight last shoes (made without a curve in the bottom of the show) may be prescribed to help hold the forefoot in place.

For those infants with very rigid or severe metatarsus adductus, surgery may be required to release the forefoot joints. Following surgery, casts are applied to hold the forefoot in place as it heals.

How to maintain your child's cast

• Keep the cast clean and dry.
• Check for cracks or breaks in the cast.
• Rough edges can be padded to protect the skin from scratches.
• Do not scratch the skin under the cast by inserting objects inside the cast.
• Use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. 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 the cast above the level of the heart to decrease swelling.

Contact your child's physician if your child develops one or more of the following symptoms:

• fever greater than 101 degrees Fahrenheit
• increased pain
• increased swelling above or below the cast
• complaints of numbness or tingling
• drainage or foul odor from the cast
• cool or cold toes.