Our Two Year Experience of Treatment of Metatarsus-varus with Univerasal Neonatal Foot Orthotics. Deformity Assessment, Pitfalls, Tips and Treatment Success Rate

Metatarsus varus is among the commonest foot deformities in the neonate. It is generally accepted that moderate and severe deformities should be treated. We present our two year experience of treatment of metatarsus-varus with Univerasal neonatal foot orthotics (UNFO).

UNFO is a below ankle orthosis designed to gradually correct and preserve correction of metatarsus varus in the neonate. It is easily applied by the patient’s caregivers. The amount of pressure applied at the apex of the deformity is controlled by an adjustable strap.

38 patients (61 feet) with severe to moderate metatarsus-varus deformity were treated and followed up to waking age. All were evaluated and treated by one pediatric orthopedic surgeon. The severity of the deformity was assessed utilizing the heel bisector line, and the rigidity according the ability to manipulate the foot to complete correction.

In cases of severe deformity treatment was started when the patient was first seen. Otherwise treatment was postponed up to age of 5 to 6 months to allow spontaneous resolution of the deformity. Average age at the beginning of treatment was 6.24 months (range 4-10). The average age at the end of the follow up was 18.7 months. The end treatment results were evaluated by an experienced Pediatric Orthopedic surgeon who examined the digital photos of all the patients and was blinded to details of each photo. All deformities improved significantly within 3 weeks of treatment initiation with good results maintained at walking age in 32 infants. Partial recurrence of the deformity occurred in 6 patients.

Minor side effects as redness of the skin, superficial bruising or excessive sweating occurred among 13 patients and resolved uneventfully.

We conclude that UNFO is an effective treatment modality for moderate to severe metatarsus varus in children younger than 10 months with persistent clinically significant metatarsus varus.