CHARLES J. ODGERS, M.D., Resident, Orthopaedic Surgery

ROBERT P. STANTON, M.D., Attending Pediatric Orthopaedic Surgeon

April 10, 1996






A 2+1 year-old boy was seen at A.I. duPont Institute for evaluation of intoeing. He had been previously diagnosed with bilateral metatarsus adductus at another institution. His prior treatment consisted of serial casting for eight weeks begun shortly after birth, followed by corrective shoes until age 12 months. His parents felt that the metatarsus adductus had improved since birth, however they still had concerns over the residual deformity. They denied that their child had any functional problems. There was a positive maternal family history of "intoeing" which was treated with a Dennis Browne bar and corrective shoes.

Initial Exam

Examination revealed a well-appearing child. He had bilateral mild internal tibial torsion, however the major component of his intoeing appeared to be secondary to bilateral metatarsus adductus deformities which were supple and flexible and they were both able to be corrected to neutral position.


The patient did not have x-rays of his feet at this time. The working diagnosis remained metatarsus adductus, and the patient was recommended to wear straight last shoes to see if that would obtain further correction. He was told to return in six months at which time AP and lateral x-rays of both feet would be obtained.


The patient returned for follow-up, now 5+1 years-old. His mother stated that he still had residual intoeing, and he appeared more clumsy with gait than other children his age. She was concerned that his metatarsus adductus had not corrected, and she wanted to know if anything more could be done. The patient still had not had any functional problems, nor had he any shoewear problems. Examination revealed bilateral flexible metatarsus adductus deformities. There was no evidence of any skin breakdown or callous formation. He did have a noticeable valgus right heel with a less obvious left heel valgus deformity. His subtalar motion was maintained. AP and lateral standing radiographs were obtained.


Clinical Features
Radiographic Evaluation
Natural History- unknown
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