Sickle feet, also known as metatarsus adductus or metatarsus varus, is a common infant foot condition. It involves an inward turning of the front part of the foot. This condition is usually noted shortly after birth and is often treatable.
What is Sickle Feet?
Sickle feet describes a foot deformity where the forefoot curves inward relative to the heel. This inward bend creates a “C” or “bean” shape, while the heel and ankle remain aligned. It can affect one or both feet.
This condition is distinct from clubfoot (talipes equinovarus), a more severe congenital deformity affecting the entire foot, including the ankle and heel. Clubfoot often presents with a stiff foot turned inward and downward, sometimes with the sole facing sideways or upwards, due to shortened tendons and ligaments. In contrast, sickle feet primarily involves the forefoot’s inward curvature, and the hindfoot maintains normal mobility.
Why Does it Occur?
The most common explanation for sickle feet is the baby’s position within the uterus before birth. Limited space inside the womb, such as in first or twin pregnancies, or with reduced amniotic fluid, can cause the feet to be held in an inward-turned position. This intrauterine compression leads to the curvature.
While intrauterine positioning is a primary factor, genetics can also play a role, as a family history may increase the likelihood. Less commonly, minor bone malformations in the foot can contribute. Sickle feet can be flexible, meaning the foot can be gently straightened by hand, or non-flexible, indicating more rigidity. Flexible cases are more prevalent and often improve without specific intervention.
Addressing Sickle Feet
Diagnosis of sickle feet typically occurs during routine physical examinations shortly after birth. A healthcare provider identifies the condition through visual inspection and by physically manipulating the infant’s foot to assess flexibility. While diagnostic procedures are not usually necessary, X-rays may be performed for non-flexible or severe cases to understand the bone structure.
Management varies based on the foot’s flexibility and the severity of the inward curve. For many infants with flexible feet, simple observation is sufficient, as the condition often resolves on its own as the child grows, frequently by 12 months of age. Parents may be instructed on passive stretching exercises to gently manipulate the foot several times a day, encouraging proper alignment.
If the foot is more rigid or does not improve with stretching, serial casting may be recommended. This involves applying a series of plaster casts, changed every one to two weeks, to gradually stretch soft tissues and reposition the forefoot. In rare instances where conservative treatments are unsuccessful or the deformity is severe, surgical intervention might be considered, typically after age four. The long-term outlook for children with sickle feet is positive, with most cases resolving fully, often without complex treatments, allowing for normal foot function and development.