Metatarsus Adductus

Original Editor - Shaniel Walters



Metatarsus Adductus ( Hooked Foot)

Common foot deformity seen in children which causes the foot to turn inwards. The foot appears "c-shaped. This condition is often associated with hip dysplasia.


Metatarsus Adductus may be classified as:

Flexible: Presents with adduction of the 5 metatarsal bones at the tarsometatarsal joint.

Rigid: Presents with medial subluxation of the tarsometatarsal joints. There is valgus of the hindfoot and the navicular is later to the head of the talus.

Bones of the Foot.jpg

Clinically Relevant Anatomy

The skeleton of the foot is made of the thirty three bones, twenty six six joints and over a hundred muscles, ligaments and tendon. The foot serves primarily as a weight-bearing joint and provides a stable base of support on which to stand. Ligaments are attached to the bones which creates joints. The anatomy of the foot is divided into 3 categories: the Forefoot, the Midfoot and the Hindfoot.

Hindfoot is comprised of : Tibiofibular joint , Talocular joint and the Subtalar (Talocalcanean) joint.[1]

Midfoot (Midtarsal Joints) is comprised of: Talocalcaneonavicular Joint, Cuneonavicular Joint, Cuboideonavicular Joint, Intercuneuform Joints, Cuneocuboid joint and the Calcaneocuboid Joint.[1]

Forefoot is comprised of: Tarsometatarsal Jointts, Intermaetatarsal Joint, Metatarsophalangeal Joints and Interphalangeal Joints.[1]

Epidemiology and Etiology

There is an incidence of 1 in 100 to 1 in 5,000 live births.[2] The cause of metatarsus adductus remains unknown. It is however, thought to be related to intrauterine compression. Family history may also be a causative factor. Other theoriespof causal relation includes abnormal tendon insertion of tibialis anterior, tibialis posterior and abductor hallucis muscles.[3]

Clinical Presentation

The forefoot is adducted and sometimes supinated , but the midfoot and hindfoot are normal. There is convexity of the lateral border of the foot, with concavity of the medial border. Older children may present with an in-toeing gait.

Diagnostic Procedures

add text here relating to diagnostic tests for the condition

Management / Interventions

Specific treatment for metatarsus adductus is often determined by the following factors:

  • Child's Age
  • Medical History
  • Extent of the condition
  • Tolerance for the specific procedure
  • Expectations for the condition
Interventions include:
  • Passive Stretching
  • Passive Manipulation exercises
  • Stretching
  • Serial Casting
  • Footwear
  • Surgery to release the joints


Generally excellent. Most cases of metatarsus adductus often resolves on its own


  1. 1.0 1.1 1.2 Magee, D. J. (2008). Orthopedic physical assessment. St. Louis, Mo: Saunders Elsevier.
  2. Wildhe T.Foot deformities at birth: a longitudinal prospective study over a 16 year period. J Pediatric Orthopedic. 1997;17(1):20-24
  3. Hassan N, Roger J (2015) Management of Metatarsus Aductus, Bean-Shaped foot, residual clubfoot adduction and Z-shaped foot in children, with conservative treatment and and double column osteotomy of the first cuneiform and cuboid. Ann Orthop Rheumatol3(3):1050.