If your child is frequently tripping and his toes are pointing inward, he might have a foot type referred to as metatarsus adductus.  This type of foot anomaly commonly gives rise to a pigeon-toed appearance. By definition, the bones of the forefoot turn inward with this foot type. Metatarsus adductus is one of the most common congenital deformities, with an occurrence in about 0.1% of newborns.  Moreover, it appears to be more commonly seen in first-born children. There are multiple causes of metatarsus adductus, such as the position of the baby in the uterus, not enough amniotic fluid produced by the mother, or abnormal muscular or tendinous insertion in the foot.

In 90% of cases, metatarsus adductus resolves without treatment. If this problem persists, it can be corrected. To improve prognosis, it is best to start treatment shortly after birth.

Treatment depends on how rigid the deformity is and the age of the child. For children under 1 year old, standard treatment consists in manipulation and serial casting.  If the problem improves, the child may need to wear a splint or special type of shoes to hold the foot into a more corrected position until the deformity corrects itself.

Surgery may be needed with very rigid or severe deformity but this is not very common. Most surgeons will delay surgical correction of metatarsus adductus until the child is at least 4-6 years old.

A child with intoeing should be evaluated by a podiatrist for further medical management.

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