CONGENITAL METATARSUS VARUS

Report of 300 Cases

¹ Scottish Rite Hospital for Crippled Children, Dectur

Congenital metatarsus varus may be thought of as being "a third of a club foot". The condition has been occurring with increasing frequency during the last few years. The adduction and inversion of the fore part of the foot, which are frequently overlooked at birth, become more marked during the first few months of life, due to the strong pull of the anterior tibial muscle.

Cases of metatarsus varus have been divided info two groups. The smaller group, consisting of more severe cases with a strong hereditary tendency and associated congenital deformities, are most resistant to treatment. The patients in the larger group show no hereditary tendency or allied deformities, other than those associated with the feet, and have no fixed deformity of the heel. They respond readily to treatment and show little tendency to recurrence. This group is increasing.

Six criteria are necessary to make the diagnosis. From the functional viewpoint, the foot is always pulled in and up; and from the structural viewpoint, there is adduction and inversion of the fore part of the foot, a higher arch than normal, a prominence on the lateral border of the foot, and greater rigidity of the foot, which cannot be abducted past the midline.

Three hundred cases have been studied. The treatment has been by casts and wedgings, similar to those used for the correction of the adduction deformity in club-foot, care being taken not to produce a flat-foot deformity.

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