Metatarsus adductus and skewfoot deformity.

Metatarsus adductus deformity should be recognized and addressed appropriately and in a timely fashion so as to achieve an effective correction with low rates of recurrence. Early diagnosis and treatment are of paramount importance, because spontaneous resolution is rare. Although nonoperative treatment is desirable via manipulation and soft tissue stretching and serial cast immobilization, appropriate surgical intervention needs to be used on occasion to achieve correction of resistant cases. Depending on the severity and flexibility of the deformity and the age of the patient, various methods of surgical reconstruction are available. A long-standing untreated or undertreated adductus deformity can lead to the formation of a skewfoot deformity with more significant symptoms and deformity. Treatment of this deformity is rarely successful by nonoperative means, and appropriate surgical procedures addressing the metatarsal adductus component and the flatfoot component can be used for correction of the dysfunctional or symptomatic skewfoot.