Metatarsal valgus is a condition where the foot bones are displaced or rotated outward, causing pain and balance issues. Treatment depends on severity, with passive stretching and orthotics for mild cases and casting or surgery for severe cases. It can also cause hallux valgus, where the big toe moves into the second toe.
The metatarsals are the five long bones located between the tarsus, the seven bones that make up the ankle, and connect the lower leg to the foot and phalanges or toe bones. Metatarsus valgus is a condition in which this entire part of the foot is displaced or rotated outward away from the body. The heel, however, also called the calcaneus, remains in its correct position.
Commonly a congenital deformity that occurs before or shortly after birth, metatarsal valgus can affect how the body handles weight bearing and walking by changing the structure of the foot and flattening the natural arch. When your body weight rests on an improperly positioned foot, it can throw you off balance and cause pain problems that can radiate through your ankles, legs, hips, and even your back. In extreme cases metatarsal valgus can cause a condition called hip dysplasia, in which the hip joint becomes distorted causing problems with the leg’s ability to swing when attempting to take a step.
The malformation of the bones in the foot known as metatarsus valgus can also affect the toes and cause a condition known as hallux valgus, in which the big toe moves into the second toe. This can also alter the dynamics of the normal heel-to-toe step sequence and cause balance difficulties. Pain may radiate from the toes due to pressure from the first toe pressing on the rest of the toes.
Treatment of metatarsal valgus depends on the severity of the displaced bones in the foot. In mild cases, the abnormal foot position is easily moved to a more normal position through passive stretching, a technique in which there is no active contraction of the muscles attached to the bones. An orthotic worn inside shoes can help correct the deformity for mildly affected patients. Paired with a regular stretching routine, this method can push bones back into place and relieve movement, balance, and pain.
In severe cases, especially when the bones are rigidly fixed and cannot be moved into a normal position, casting may be necessary to fix the bones in their natural position. The foot is stretched several degrees closer to normal and a cast is placed that extends beyond the knee for up to two weeks. This process is repeated several times until the foot regains its natural shape. Casting for metatarsal valgus can be effective during the first few years of life up to the age of four or five.
If the cast is ineffective or the condition is present after the age of five, surgery may be needed to correct the deformity. Surgery for metatarsal valgus commonly involves an osteotomy of one or more bones to regain correct positioning. An osteotomy is a procedure in which bones are cut to change their alignment.
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