In Toeing or metadductus is a condition of the foot where there is an increased curvature of the forefoot and gives a C- shaped appearance. The metatarsals are deviated towards the middle. Exact cause of metadductus is not fully known, some people believe congenital, intra-uterine position and pressures during pregnancy. Can be either flexible when the foot can be straightened by the hand or non flexible
Metadductus or in toeing is diagnosed by physical examination and x-ray. The foot has a concave border medially and a convex laterally and there is an inward position of the foot to the lower leg.
Most children with a flexible metatarsus adductus deformity can be treated with conservative measures with stretching, strengthening, braces, casting or orthosis. Casting is usually recommended until the deformity is reduced and then a couple weeks after to ensure no reoccurrence. Casting works better before the child starts to ambulate. Some cases of metaductus will resolve once the feet are used normally. However, if surgery is required there are several different procedures depending on the age of the patient, magnitude of the deformity and whether it’s flexible or non-flexible.
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