METATARSUS ADDUCTUS

Question 1

most common foot deformity of infancy?

Answer 1

metatarsus adductus

Question 2

does a 3 week old child need a cast who has metatarsus adductus?

Answer 2

nope

Question 3

classification system for metatarsus adductus?

Answer 3

beta classification

• simple
• complex
• complex skew
• onse study has shown the system to be difficult to reproduce in both intra-rater and inter-rater reliability for measuring on radiographs

bleck classification (severe, rigid)

• severity is determined primarily by the bisection of the foot relative to the toes
• amount of curvature of lateral border of the foot generally worse with increasing severity
• may have associated transverse skin crease from medial to lateral at mid tarsal joint

Question 4

t/f, may be associated with tight abductor hallucis m

***bisection of foot should go through toe 2 or between toes 2 and 3 with metatarsus adductus if it is lateral to toe 3

Answer 4

t

Question 5

this is the test for abductor hallucis muscle tightness?

Answer 5

lichtblau test, positive if muscle fires or get blanching of skin over tendon or muscle belly

Question 6

adduction and inversion of metatarsus relative to normal position of rearfoot, what is this foot condition?

Answer 6

metatarsus adductovarus

Question 7

how to measure MA in infants? older children?

Answer 7

line parallel to lateral border of calcaneus relative to a line bisecting the second ray

a line perpendicular to the transverse bisection of the mid foot bones relative to a line bisecting the 2nd metatarsal; normal is 8-15 degress

Question 8

metatarsus varus creates?

Answer 8

pronation of the STJ on WB

Question 9

generally no tx indicated because it resolves by 12 weeks of age, T/F?

Answer 9

true

Question 10

bracing shoe therapy is worn how many hours daily?

Answer 10

18-22 hours daily, not plantar arch

Question 11

t/f, universal neonatal foot orthotics is a non weight bearing brace and applied with continuous corrective force?

Answer 11

true

Question 12

remember image of bebax shoe? bonus on exam

Answer 12

see other side

Question 13

brace for moderate semi flexible deformity?

Answer 13

Wheaton brace

Question 14

what is true about casting technique?

remember for exam, cast must extend past end of toes or may result in hallux varus; should still be able to see all toes

Answer 14

see other side

Question 15

what is the next step after the casting period?

Answer 15

bracing