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

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MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

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.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Azienda Ospedaliera Maggiore della Carita di Novara, Novara, Italy

    G. Rocca, A. De Venuto & G. Colasanto

  2. 1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy

    S. O. Zielli, A. Mazzotti & C. Faldini

  3. Department of Biomedical and Neuromotor Sciences, University of Bologna, 40123, Bologna, Italy

    A. Mazzotti & C. Faldini

Authors
  1. G. Rocca
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  2. A. De Venuto
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  3. G. Colasanto
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  4. S. O. Zielli
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  5. A. Mazzotti
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  6. C. Faldini
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Corresponding author

Correspondence to A. Mazzotti.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All the patients and parents provided their informed consent at admission on data collection and reporting.

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Rocca, G., De Venuto, A., Colasanto, G. et al. Congenital metatarsus varus: early diagnosis and conservative treatment in 112 patients. Musculoskelet Surg 107, 379–384 (2023). https://doi.org/10.1007/s12306-022-00751-0

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  • DOI: https://doi.org/10.1007/s12306-022-00751-0

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