The clubfoot is classified according to the severity and mobility of the deformity:

1. According to severity:

- Mild: Slight deviation of the forefoot, hardly visible deformity.

- Moderate: Clearly visible curvature of the forefoot with limited mobility.

- Severe: Strong deviation with pronounced deformation.

2. According to mobility:

- Flexible clubfoot: The deformity can be passively corrected.

- Rigid clubfoot: The deformity is fixed and cannot be passively corrected.

The causes of metatarsus adductus are usually congenital but can also be exacerbated by external influences:

• Congenital causes:
  • Lack of space in the womb, e.g., in multiple pregnancies or a narrow uterus.
  • Inherited misalignments due to familial predisposition.
• Acquired causes:
  • Improper load on the foot in the first years of life due to incorrect footwear.
• Accompanying factors:
  • Association with other foot deformities, such as clubfoot or flatfoot.

The symptoms depend on the severity of the misalignment and typically include:

- Deviation of the forefoot: Visible inward curvature of the front part of the foot.

- Asymmetrical gait pattern: The foot rolls unevenly, which can lead to load problems.

- Pressure points and calluses: Due to uneven pressure distribution, especially in more severe cases.

- Movement restrictions: Difficulties in extending or rolling the foot.

- Pain: Rare, but possible in pronounced misalignments.

The diagnosis is made through medical history, clinical examination, and, if necessary, additional procedures:

• Medical history:
  • Collection of medical history, pregnancy course, and family predisposition.
• Physical examination:
  • Visual and palpation findings to assess foot position and mobility.
  • Examination of gait pattern and load distribution.
• Imaging:
  • X-ray: Visualization of bony structures, especially in rigid deformities.
  • Pedography: Analysis of pressure distribution on the sole of the foot.

The treatment depends on the severity and mobility of the deformity:

Conservative Therapy

For flexible deformities and mild to moderate severity, conservative treatment is often sufficient:

• Stretching exercises: Regular manual correction by parents or physiotherapists to correct the deformity.
• Splints and orthoses: Special aids for passive correction of the foot, especially at night.
• Physiotherapy:
  • Targeted exercises to strengthen the foot muscles and promote mobility.
  • Massage of the sole of the foot to support the correction.
• Suitable footwear: Use of spacious and flexible shoes that do not constrict the foot.

Surgical Therapy

In cases of rigid deformities or unsuccessful conservative treatment, surgery may be necessary:

• Soft tissue correction: Lengthening or release of shortened tendons and ligaments.
• Bone interventions: Correction of the bony deformity, especially in severe deformities.
• Post-treatment: Use of plaster casts or orthoses for stabilization after surgery.

To prevent clubfoot or to support treatment, the following measures are helpful:

1. Early detection: Regular examinations of newborns and toddlers to detect foot deformities.
2. Targeted exercises: Promoting natural foot development through walking barefoot and foot gymnastics.
3. Avoidance of improper footwear: Ensuring that children's shoes provide enough space and are flexible.
4. Timely treatment: Seek medical advice early at the first signs of a deformity.