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Below-knee plaster cast for the treatment of metatarsus adductus
1Department of Orthopedics, Schneider Children's Medical Center of Israel, Petah Tiqva.
Insights
Below-knee plaster casts effectively treat infantile metatarsus adductus. This method achieved correction in 6-8 weeks, with lasting results at a 4-year follow-up, proving its efficacy.
Area of Science:
- Pediatric Orthopedics
- Podiatry
- Biomechanical Engineering
Background:
- Metatarsus adductus is a common congenital foot deformity in infants.
- Inflexible metatarsus adductus requires effective treatment to prevent long-term complications.
- Current treatments include various casting methods, with ongoing evaluation of efficacy.
Purpose of the Study:
- To evaluate the effectiveness of below-knee plaster casts in treating moderate and severe inflexible metatarsus adductus in infants.
- To assess the long-term maintenance of correction after below-knee cast treatment.
- To compare the outcomes of below-knee casting with those of traditional above-knee casting.
Main Methods:
- A cohort of 65 infants with moderate or severe inflexible metatarsus adductus was treated.
- Treatment involved the application of below-knee plaster casts.
- Patients were followed for 2 to 6 years (mean 4 years) to assess correction and recurrence.
Main Results:
- Complete correction of metatarsus adductus was achieved in all infants within 6-8 weeks.
- Correction was maintained long-term in all cases of moderate deformity.
- Of severe cases, 86% showed maintained or improved correction at follow-up, with no further treatment needed.
Conclusions:
- Below-knee plaster casting is a highly effective treatment for infantile metatarsus adductus.
- This conservative approach offers durable correction, even for severe deformities.
- Results are comparable to more extensive above-knee casting methods, suggesting a simpler treatment option.
Abstract:
Sixty-five infants with moderate (37 feet) or severe (48 feet) inflexible metatarsus adductus were treated with a below-knee plaster cast. The deformity was corrected in 6-8 weeks in all cases. At the 2- to 6-year follow-up (mean, 4 years), the correction was maintained in all children who had had a moderate deformity; of the 44 feet with severe deformity that were available for examination, six now had a moderate deformity, and one a severe deformity. All forefeet were flexible, and further treatment was unnecessary. Our results are similar to those for above-knee plaster casts. We conclude that a below-knee plaster cast is effective in the treatment of metatarsus adductus.