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Does the parental stretching programs improve metatarsus adductus in newborns?
Perajit Eamsobhana1, Karn Rojjananukulpong1, Thanase Ariyawatkul1
1Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Parental stretching offers no significant benefit for newborn metatarsus adductus (MA) compared to observation. For moderate-to-severe MA, observation and later casting if needed remain the recommended approach.
Area of Science:
- Pediatrics
- Orthopedics
- Podiatry
Background:
- Metatarsus adductus (MA) is a frequent pediatric foot deformity.
- Current guidelines recommend observation until 4-6 months, followed by casting if the deformity persists.
- No randomized controlled trials have evaluated parental stretching for newborn MA correction.
Purpose of the Study:
- To investigate the effectiveness of a parental stretching program for correcting metatarsus adductus in newborns.
- To compare the success rates of parental stretching versus observation in infants with MA.
Main Methods:
- Ninety-four newborn feet diagnosed with MA were randomized into an observation group and a stretching group.
- Outcome measurements were used to compare the success rates between the two groups.
- Pearson's chi-squared test was employed for statistical analysis.
Main Results:
- No statistically significant differences in overall success rates were found between the parental stretching and observation groups (p=0.191).
- Subgroup analysis for mild or moderate-to-severe MA also showed no significant differences (p=0.134, p=0.274).
- While the stretching group showed a faster initial improvement, the observation group tended to have a slightly better outcome in moderate-to-severe cases, though not statistically significant.
Conclusions:
- Parental stretching provided no demonstrable benefit over observation for newborn metatarsus adductus in this study.
- The use of parental stretching for moderate-to-severe MA in newborns is not recommended due to a potentially lower success rate compared to observation.
- Continued observation until 4-6 months, with corrective casting for persistent deformities, remains the recommended management strategy.
Background:
Metatarsus adductus (MA) is a common pediatric foot deformity. Current recommendations suggest observation until 4-6 months, then casting if the deformity persists. Based on our review of the literatures, no randomized controlled trial has been conducted to study the effectiveness of parental stretching in the correction of MA in newborn.
Material And Methods:
Ninety-four newborn feet that were diagnosed as MA by clinical examination were enrolled. Feet were randomized into two groups: observation group and stretching group. Outcome measurements were performed to compare success rate between groups.
Results:
According to Pearson's χ2 test, there were no statistically significant differences between groups with regard to the overall success of the parental stretching program ( p = 0.191). There was also no significant difference between groups for mild degree or moderate-to-severe degree ( p = 0.134, p = 0.274, respectively). A more rapid success rate was observed in the stretching group at the first month follow-up, but rate of improvement then decreased. The stretching group tended to have a lower success rate compared to the observation group in moderate-to-severe feet, but the difference was not statistically significant.
Conclusions:
Parental stretching program found no benefit over observation group in this study. Parental stretching program should not be applied for newborn babies with moderate-to-severe MA as the result from the study appeared to have lower success rate compared to observation group. Observe until 4-6 months, then corrective casting for the persisting deformity is recommended.
