Q66.2

Clinical Causes: Genetic factors that influence bone and joint development Developmental abnormalities occurring during fetal growth Associated congenital syndromes or limb deformities Environmental influences during pregnancy, although less common

Key Symptoms: Inward angulation of the big toe and front part of the foot Visible deformity in the shape of the foot, often evident at birth Potential limited mobility or difficulty fitting into shoes Possible compensatory gait patterns or imbalance while walking Minor discomfort or foot fatigue in some cases

Diagnosis Path: Diagnosis typically involves a physical examination by a healthcare professional, who assesses the alignment and structure of the foot. X-rays are often used to confirm the extent of the deformity, evaluate the bones’ development, and rule out other associated conditions. The evaluation focuses on the position of the first metatarsal, joint stability, and the overall anatomy of the foot.

Treatment Protocols: Management of congenital metatarsus (primus) varus depends on the severity and the presence of functional impairments. Common treatment options include: - **Observation:** Mild cases without significant functional impact may simply be monitored over time. - **Non-surgical interventions:** These might involve stretching exercises, orthotic devices, or footwear modifications to improve alignment and comfort. - **Surgical correction:** Severe or persistent deformities may require surgical procedures to realign the first metatarsal, lengthen or shorten bones, and restore proper foot mechanics. Postoperative rehabilitation typically includes physical therapy to regain mobility and strength. A multidisciplinary team including pediatric orthopedists, physical therapists, and podiatrists often collaborates to develop a personalized treatment plan ensuring the best functional outcome.