Metatarsus Adductus

Metatarsus Adductus (MTA) is a common foot deformity, occurring in about seven percent of all newborn infants. With MTA, the outer edge of the forefoot is turned in, and the border of the foot is no longer straight. One or both feet may be affected.

The cause of the MTA is unknown. It has been suggested that it may be congenital - the result of heredity - or caused simply by the position of the infant while in the womb.

In many infants with MTA, the problem may correct itself without treatment by the time the baby is six months old - despite the apparent severity of the case.

Stretching Exercises
Stretching exercises may also prove helpful. By exercising the baby's foot, the muscles which turn the foot outward may be stimulated. The following stretching exercise is recommended:

  1. The first step in effectively stretching your baby's foot is to grasp it properly. With one hand, place your thumb along the outside of the leg and your index finger on the inside of the heel. Use the left hand for the right foot; right hand for the left foot (Figure 1).
  2. Using the other hand, place the thumb just beneath the toes. The thumb should support all of the toes. Holed the forefoot between the thumb and the index finger (Figure 2), with the sole of the foot slightly flexed.
  3. Then push the foot horizontally outward (Figure 3). Repeat this exercise 15 times.

If the deformity persists after six to nine months of age, the use of plaster casts, orthotic devices or corrective shoes may be prescribed by the child's physician.

The baby will wear casts for six to 12 weeks, and the casts will be changed every two weeks. The cast may extend up to the knee or top of the thigh with the knee in a bent position.

Once the position of the foot is corrected, the use of prescription shoes may be required to prevent a recurrence of MTA. If treatment is successful, the child should be able to wear non-prescription shoes by the age of one year.

Occasionally, surgery may be required in late-diagnosed cases which are unresponsive or resistant to non-operative treatment. An orthopaedic surgeon can provide information on other options for treating MTA.

Cast Instructions

  1. It will take 24-48 hours for the plaster cast to dry. DO NOT lean, press or bear weight against the cast during this time.
  2. Do not allow the cast to get wet. If the cast breaks or becomes soft before your child's next appointment, please contact the orthopaedic nurse at 638-9100 or the Emergency Room at 638-9174.
  3. If you notice swelling, coolness or blue or purplish color to the toes, notify the orthopaedic nurse immediately or bring the child to the emergency room.
  4. You may wish to remove the casts at home prior to your return visit to the clinic. Mix four tablespoons vinegar with one quart warm water and soak the casts until you are able to unravel the plaster from the foot.