Understanding Metatarsus Adductus in Infants
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Metatarsus adductus is a common condition in which a baby's forefoot curves inward toward the midline of the body. Most flexible cases correct themselves by the first birthday, while rigid or severe cases may need stretching, corrective shoes, or casting [1].
Quick Answer: What is metatarsus adductus?
Metatarsus adductus is a congenital foot condition in which the front half of a baby's foot curves inward, and it is the most common foot deformity in newborns. It is thought to result from crowding in the uterus or genetics. Flexible cases often resolve by the first birthday, while rigid cases may need stretching, corrective shoes or casting. [1]
What the research says
Flexible cases generally need no treatment. A systematic review of 13 articles on conservative care (no treatment, stretching, splinting, serial casting, positioning, and footwear or orthotics) found strong evidence supporting no treatment for flexible metatarsus adductus, and only limited evidence for treating semi-rigid cases (Williams et al., J Paediatr Child Health, 2013 [2]).
Several non-surgical options correct the curve, but they differ in side effects. A systematic review that screened 200 studies and analyzed the 11 that met its criteria found that the Wheaton brace, rigid strap, manipulation exercises, reverse-last shoes, and plaster casts can all achieve good correction, and that the Wheaton brace and Bebax shoe appeared to cause fewer complications than other methods (Karimi et al., J Foot Ankle Surg, 2022 [3]).
A simple foot orthosis helped most babies with moderate to severe cases. In a case series of 73 infants aged 4 to 11.5 months with moderate to severe metatarsus adductus, a universal neonatal foot orthosis worn 23 hours a day led to significant improvement in 56 of the 71 children followed (98 feet), while 11 showed no change and 3 got worse; minor side effects occurred in 11 children and all resolved (Panski et al., Eur J Pediatr, 2021 [4]).
What is metatarsus adductus, and how common is it in infants?
Metatarsus adductus is the most common foot deformity seen in newborns. It causes an inward curve that starts in the middle of the foot and extends toward the toes. About 1 in 1,000 babies are born with it, although some studies suggest that up to 12% of babies are affected. It usually affects infants and can involve one or both feet. In adults, an inward curve of this kind has most likely been present since birth [1].
It helps to tell metatarsus adductus apart from other congenital foot conditions. Clubfoot involves tight, short tendons that turn the foot in so severely that the sole faces upward or sideways, while metatarsus adductus mainly involves the alignment of the forefoot. In skew foot, the bones of the toes and heel form a Z shape, which can cause trouble with walking [1].
What causes metatarsus adductus, and what are the risk factors?
Healthcare providers are not sure exactly why some babies develop metatarsus adductus. Physical constraints in the womb and family history are the main suspected contributors [1].
Factor | Description |
Intrauterine compression | Crowding or pressure on the developing baby inside the uterus. |
Oligohydramnios | Too little amniotic fluid during pregnancy. |
Genetic predisposition | The condition may run in families. |
Associated conditions | Babies with developmental hip dysplasia or torticollis (a twisted neck) may be at higher risk. |
There is no known way to prevent metatarsus adductus [1].
What are the symptoms of metatarsus adductus in infants?
The hallmark sign is an inward turn of the outer edge of the foot and the toes. The curve may be mild or severe, and in some children the feet become rigid. Doctors usually describe two types [1].
A normal foot compared with metatarsus adductus, where the forefoot and toes curve inward.
How is metatarsus adductus diagnosed?
Providers often notice the curve at a well-baby visit, or parents may spot the feet turning inward (sometimes called pigeon toes) as the child begins to walk. A physical examination is usually enough to diagnose metatarsus adductus, and an X-ray may be recommended if the foot is rigid [1].
Gentle manipulation shows whether the forefoot is flexible or rigid and helps separate metatarsus adductus from clubfoot.
How is metatarsus adductus managed and treated?
Treatment depends on how flexible the foot is and how old your child is. Many babies grow out of metatarsus adductus by their first birthday without any treatment [1].
Non-Surgical Interventions
If the feet are still curved by the first birthday, or if they are rigid, a provider may recommend seeing a pediatric orthopaedist. The options are designed to reshape the foot's tissues and bones [1].
Stretching exercises: gentle stretches of your child's feet that your provider may recommend you do together [1].
Corrective shoes: shoes that help reshape the foot's tissues and bones [1].
Serial casting or splinting: casts or splints that providers change weekly to straighten the foot gradually [1].
Stretching, corrective footwear, and serial casting are the main non-surgical treatments.
Surgical Considerations
Surgery is rare. Your provider may recommend it only if metatarsus adductus remains severe and has not resolved by about age 10 [1].
What is the long-term outlook for metatarsus adductus?
Most babies grow out of metatarsus adductus in early childhood. Your child may need several appointments so the provider can check whether the feet are straightening or whether further treatment is needed, and if a cast is used it is changed weekly. Bring your child to every scheduled checkup. There is usually no need to limit your child's activity unless your provider advises it, and children with metatarsus adductus can lead healthy, active lives [1].
What is the bottom line on metatarsus adductus in infants?
Metatarsus adductus is common and manageable. An inward-curving forefoot can be alarming for parents, but most cases resolve on their own or with minimal treatment, and early identification at well-baby visits makes sure your child gets either simple observation or specialist care as needed. If you notice an inward curve in your child's feet or have concerns about how they walk, schedule a visit with a pediatrician or pediatric orthopaedist.
Frequently Asked Questions
What is the primary sign of metatarsus adductus?
The most visible sign is an inward curve of the front part of the foot and the toes, often affecting the outer edge of the foot.
How common is metatarsus adductus in newborns?
Metatarsus adductus is the most common foot deformity in babies. About 1 in 1,000 babies are born with it, and some studies suggest it may affect as many as 12%.
Will my baby need surgery for metatarsus adductus?
Surgery is very rare. It is usually considered only if the condition stays severe and has not resolved by about age 10.
Can metatarsus adductus be prevented?
There is no known way to prevent it, as it often results from factors such as crowding in the uterus or genetics.
What is the difference between metatarsus adductus and clubfoot?
Clubfoot is more severe. Tight, short tendons turn the foot in so much that the sole faces upward or sideways, whereas metatarsus adductus mainly affects the alignment of the forefoot.
What causes a baby to be born with metatarsus adductus?
Possible causes include crowding in the uterus, low amniotic fluid (oligohydramnios), and genetic factors. Providers are not sure exactly why it happens.
How do doctors diagnose metatarsus adductus?
Diagnosis is made mainly through a physical exam. An X-ray may be used if the foot is rigid.
At what age should I seek treatment for my child?
Many cases resolve by age one. If the feet are still curved by the first birthday, or if they are rigid or the curve is severe, a provider may recommend treatment.
What non-surgical treatments are available?
Common options include stretching exercises, corrective shoes, and casts or splints that are changed weekly.
Can adults have metatarsus adductus?
Yes, although it is rare. An adult with an inward-curving foot has likely had the condition since birth. A podiatrist can advise, and special shoes may help correct it.
References
Cleveland Clinic. Metatarsus Adductus. Cleveland Clinic. May 2, 2022. https://my.clevelandclinic.org/health/diseases/22911-metatarsus-adductus
Williams CM, James AM, Tran T. Metatarsus adductus: development of a non-surgical treatment pathway. J Paediatr Child Health. 2013;49(9):E428-E433. PMID 23647850. https://doi.org/10.1111/jpc.12219
Karimi M, Kavyani M, Tahmasebi R. Conservative treatment for metatarsus adductus, a systematic review of literature. J Foot Ankle Surg. 2022;61(4):914-919. PMID 35216881. https://doi.org/10.1053/j.jfas.2022.01.016
Panski A, Goldman V, Simanovsky N, et al. Universal neonatal foot orthotics: a novel treatment of infantile metatarsus adductus. Eur J Pediatr. 2021;180(9):2943-2949. PMID 33835248. https://doi.org/10.1007/s00431-021-04048-5
Medical disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. The clinical information in this guide reflects source material last reviewed in May 2022.
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