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Detailed information of METATARSUS VARUS
METATARSUS VARUS
DEFINITION:
A skeletal disorder characterized by adduction and inversion of
the metatarsal bones resulting in in-toeing.
EPIDEMIOLOGY:
- incidence: ?
- age of onset:
- risk factors:
- may be associated with congenital dislocation of the hips
PATHOGENESIS:
- due to in utero subluxation
- a fixed deformity
- does not correct spontaneously after birth
- may be bilateral or unilateral
- also involves medial subluxation of the tarsometatarsal
joints
2. METATARSUS VARUS
- due to an in utero positional deformity
- a flexible deformity - the forefoot can be brought into
the neutral position
- spontaneous resolution in 90% of cases by 3 months of age
- may be bilateral or unilateral
- also may involve contractures of the medial soft tissues
of the foot
CLINICAL FEATURES:
- the forefoot (metatarsals) is held in varus relative to the
hindfoot, i.e., the forefoot is rotated inwardly
- the lateral border of the foot is convex while the medial
border is concave
- a line bisecting the heel passes lateral to the 2nd and 3rd
toes (this line normally passes between the 2nd and 3rd toes)
- increased web space between the great and 2nd toes
- prominent base of the 5th metatarsal
- the heel and hindfoot are in a normal position with easy
passive dorsiflexion at the ankle
INVESTIGATIONS:
- not necessary for the diagnosis
MANAGEMENT:
- as the deformity is fixed, passive manipulation and casting
are corrective with reverse-last or straight-last shoes acting
as long-term holding devices
2. Surgery
- between the ages of 3-6 years, soft tissue releases of the
tarsometatarsal joints may be required followed by casting -
over the age of 7 years, metatarsal osteotomy may be required
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Pediatric Database - METATARSUS VARUS
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