MTA is a relatively frequent and underestimated deformity (up to 7% of the population), in some cases it reaches and exceeds the incidence of valgus calcaneum, more simply understood as, a specific form of clubfoot characterized by dorsiflexion, eversion and abduction of the foot. Given the high incidence and the large percentage of underestimated cases (about 85%) the risk of progression and residual deformity and rigidity is high.
The primary goal of common treatment for metatarsus adductus is to straighten the forefoot and the heel through stretching, casts and surgery. Treatment recommended for metatarsus adductus is dependent on the severity of the condition and may include practices such as; observation, stretching, casting or surgery. Many have stated that a child’s foot straightens as they grow, thus treatment being unnecessary. According to recent studies, only 80 to 85 percent of mild cases of MTA can be resolved without treatment. Contrary to popular belief, all moderate to severe cases that are not flexible – require treatment.
Luckily, metatarsus adductus may be the most common deformity among infants, but it is also the one that can be treated with the most success, when treatment is started in the child’s early months – preferably before the age of nine months. At the birth of your newborn, an exciting special time, taking this risk with no guarantee is one worth questioning appropriate and effective treatment for. Why take the gamble on your child’s future?
With each of these common treatment options it is important to note their standstill in medicine. Across the globe, up until only a few years ago, castings were the only acceptable method of treatment for metatarsus adductus for the past 200 years. The casting method has not always been proven successful. It has been observed that although the correction was achieved, the problem recurred after the treatment was discontinued. Complications and difficulties with this casting method, brought doctors to give up treating mild to moderate cases and solely treat severe cases. Parents concerned with mild and moderate MTA in their child often turn to the “wait and see” method, due to the limited effective solutions.
Stretching and physiotherapy, often recommended by physicians, has never been proven as an effective treatment for MTA. As mentioned before, in order to achieve successful results, the treatment must begin before the age of 9 months. Treatments after the age of 10 months are less successful. It is important to note that, any delay in diagnosis and treatment might be significant in the child’s adult life, hamper treatment and leave him with a deformed and unstable gait, and side effects when older. These side effects can include pain, rapid shoe wear out, stress fractures on the outer side of the foot (the fifth metatarsal bone), hallux valgus (“bunion”) and mallet toe. Additionally, children born with metatarsus adductus may have a higher risk for developmental dysplasia of the hips.