How to Treat and Identify Metatarsus Adductus (In-toeing, Pigeon Toes)

Identifying and treating metatarsus adductus is sometimes difficult because of the different severities of deformity. A mild case may need no treatment at all. Both moderate and severe cases will need treatment by a professional.

Instructions

Difficulty: Moderate

Things You’ll Need:

• a very good orthopedic surgeon.
• a support group (on-line or otherwise)
• the internet

1. During pregnancy, a fetal sonogram may diagnose clubfoot or metatarsus adductus. As both these conditions look similar during pregnancy, it is difficult to be sure until the baby is born. Often the perinatologist will suggest further testing and a second opinion.
2. Get your second opinion from a qualified perinatologist, not your OBGYN.
3. If your second opinion confirms the first opinion, educate yourself. Join the "yahoo.news group nosurgery4clubfoot" and read what the other parents have to say. Maybe you don't know what to ask, but at the very least, you will read and see you are not alone and that your baby will recover to live a normal healthy life.
4. Find a Ponseti certified Dr. Do not go to any other orthopedic surgeon for a consultation before the baby is born. Ponseti certified doctors are trained to treat clubfoot and MTA (metatarsus adductus) without surgery, through a series of casting and either shoes on a bar or braces. (you can ask the yahoo support group for help finding a doc. in your area)
5. After your baby is born, enjoy him or her for the first three weeks without any visits to any doctors concerning the feet. After three weeks, you should see your Ponseti certified doctor for his/her opinion. It may very well be different than when you first consulted him/her prenatally.
6. Kidney Shaped Foot A clue that your baby may actually have metatarsus adductus is that his/her feet will be "kidney" shaped, rather than straight. Another clue may be that the baby stands on his/her ankles instead of flat footed. The foot should be somewhat flexible. If not, your baby may actually have clubfoot. However, you should know that a clubfoot may also be flexible.
7. If your baby has been diagnosed with a mild "MTA", probably nothing more than simple stretches and exercises will be recommended.
8. Markell Open Toed Straight Last Shoes on Denis Brown Bar Moderate/Mild MTA Diagnosis:
   Probably only open last shoes on a bar will be recommended. Occasionally casting will be recommended.
9. Bilateral Full Leg Casts Severe MTA Diagnosis:
   Casting and open last shoes on a bar will be recommended. (remember, it is always better to over treat than under treat as relapses may occur)

Tips & Warnings

• Metatarsus Adductus is a congenital birth defect caused by fetal position in the uterus. Was your baby breech?
• Clubfoot is a congenital birth defect, not believed to be caused by fetal position. Do you have a history of clubfoot in the family?
• Dr. Ponseti's research: truly_clubfoot.tripod.com/PonsetiBook.pdf
• If you are not satisfied with any doctor, please seek a second opinion. Metatarsus Adductus and Clubfoot are best treated before 1 year of age.