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What additional information would you want to collect?

Occasionally, a foot may be turned awkwardly (clubfoot, metatarsus adductus [MA], congenital vertical talus, cavovarus foot deformity), or legs might be fixed straight up with the feet near the ears (congenital knee dislocations), or the neck may be tipped to one side (torticollis) (Garzon et al., 2025). The first thing that needs to be done is to rule out any potential underlying medical causes for the foot deformity. This can be done through a thorough medical history and physical examination. If any concerns about an underlying medical condition causing the deformity, further testing such as imaging studies or blood work may be ordered. To determine whether the foot is flexible or rigid, the heel is grasped with one hand while the forefoot is abducted with the other (Garzon et al., 2025).

What management do you initiate?

Management is based on the rigidity of the deformity; most pediatric patients respond to nonoperative treatment (Metatarsus Adductus, n.d.). The doctor will examine the child’s foot and may order X-rays to get a better look at the foot. If the doctor believes that the child’s foot is simply curved due to the way they are standing or walking, the family may be encouraged to help the child to stand or walk differently. A referral to orthopedics may be needed. The treatment for the child may include serial short-leg casts or braces to stretch the foot (two or three casts for 2 weeks per cast) or other management if the bones of the foot are more severely affected. If the child is older than 2 to 3 years, surgery may be needed to correct the problem.

The grandma told the mother that placing the childâ€™s shoes on the wrong foot would fix the problem.

Grandma’s suggestion to put the child’s shoes on the wrong foot is not likely to help the child’s foot. If the child’s foot is simply curved, this will not fix the problem. If the child has a more serious condition, this could make the condition worse. The mother should follow up with the doctor to receive advice and treatment needed to help her child.

How do you respond?

Once it has been determined that the foot deformity is not being caused by an underlying medical condition, the next step is to determine the best course of treatment (Metatarsus Adductus, n.d.)t. In some cases, simply monitoring the deformity and providing supportive footwear may be all that is necessary. In other cases, however, more aggressive treatment may be needed. This could include the use of custom orthotics, physical therapy, or even surgery. The decision of which treatment option to pursue will depend on several factors, including the severity of the deformity, the age of the child, and the child’s activity level. In general, however, the goal of treatment is to improve the child’s function and prevent further deformity. Most babies with flexible metatarsus adductus improve without treatment. Gentle stretching of the foot several times a day can help. Hold the hind foot in one hand and the forefoot in the other, then stretch the midfoot to open the “C” shaped curve and slightly over-correct it (Metatarsus Adductus, n.d.). Educate the caregiver that during diaper changes, perform passive manipulation exercises on your childâ€™s feet as well as changing positions while sleeping.

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