Module 45, General Medical Level
A 2 year old boy was seen 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 which began
shortly after birth, this was followed by corrective shoes until 12 months
of age. 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.
Question 45A
Metatarsus
adductus is a mild form of club foot.
Question 45B
Metatarsus
adductus often runs in families as demonstrated in this family.
Question 45C
As
was done in this child, it is very important to start casting for correction
of the metatarsus adductus as soon after birth as is possible.
Question 45D
Infants
with metatarsus adductus have a kidney bean shape to the lateral border
of the foot and sometimes have a crease in the medial arch of the foot.
Question 45E
Use of corrective shoes either straight last or reverse last shoes is a
good treatment of metatarsus adductus.
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