Metatarsus varus

Metatarsus varus (pes adductus, metatarsus adductus) is a non-positional foot defect. Congenitally varus metatarsals can be of three types:

Bots used for treatment

This is a medial subluxation in the tarsometatarsal joints (Lisfranc joint).

requires intensive treatment
always conservative at first: start with exercise (pressure on medial surface to align foot to correct position), a series of corrective plaster bandages over the knee, modeled so that corrective pressure is directed over metatarsals laterally (duration of individual fixations 1-2 weeks, 6-8 weeks overall, rarely longer)
if the deformity persists: around the age of 2 years operations on soft tissues (tendons and joint capsules), from the age of 3 years osteotomy over the metatarsal bases followed by transfixation with Kirschner wires and plaster fixation for 6 weeks (however, it is better to wait until the child is 5-6 years old, when there is no longer a risk of injury to the growth splays)

metatarsal varicosity, heel valgus
talocrural joint in anteroposterior projection on rtg spherical
toe retracted into adduction most, forefoot creates a bayonet-like deformity (pes serpens)

treatment is initiated conservatively (RHB and cast fixation)
if unsuccessful, operate (capsulotomy, tendon intersection of m. abductor hallucis, osteotomy of the calcaneus)

References[edit | edit source]

SOSNA, A. – VAVŘÍK, P. – KRBEC, M.. Základy ortopedie. 1. edition. Triton, 2001. ISBN 80-7254-202-8.