Congenital metatarsus varus: early diagnosis and conservative treatment in 112 patients.

Abstract

PURPOSE:

To describe a conservative treatment algorithm to manage Congenital Metatarsus Varus.

BACKGROUNDS:

Congenital Metatarsus Varus is a congenital disorder with an estimated incidence of 1/1000 newborns. Despite the deformity being mostly an aesthetic problem, residual and incorrect forms may be responsible for abnormal in-toe gait and shoe-wearing issues. No consensus has still been gathered regarding its correct treatment algorithm.

METHODS:

Between May 2019 and September 2020, 2156 newborn patients underwent an orthopedic examination at birth. Patients affected by Congenital Metatarsus Varus were classified according to Bleck's classification as flexible, semi-flexible or non-flexible deformity. A conservative treatment algorithm was followed, based on the application of manipulations, Bebax-type braces or plaster cast. All patient were followed until the clinical resolution of the deformity. Complications were also recorded.

RESULTS:

One-hundred twenty-four patients were diagnosed Congenital Metatarsus Varus, with an overall prevalence of 5/1000. One-hundred twenty-two patients presented with a flexible or semi-flexible foot deformity and were firstly treated with manipulations: 52 patients reported good results, while 70 required additional treatment with Bebax-type braces for achieving correction. Two patients presented a non-flexible deformity at birth: one required plaster cast due to a non-flexible deformity, and one patient was firstly managed with Bebax-type braces due to a severe semi-flexible deformity. Only two patients presented superficial skin ulcerations, healed within a week. Two patients were lost during the follow-up.

CONCLUSION:

An early diagnosis allowed by an orthopedic examination in all newborns may be a valid instrument to avoid Congenital Metatarsus Varus misdiagnosis. Early treatment with manipulation and orthosis resulted in good clinical outcome, with only few complications.

• Authors: G Rocca, A De Venuto, G Colasanto, S O Zielli, A Mazzotti, C Faldini
• Journal: Musculoskeletal surgery (Musculoskelet Surg) (Jun 18 2022) ISSN: 2035-5114 [Electronic] Italy
• PMID: 35716246 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Istituto Ortopedico Rizzoli.