Early and delayed orthotic treatment in congenital metatarsus varus: effectiveness of two types of orthoses

Abstract

Aim: The aim of this study was to evaluate the effectiveness of early or delayed orthotic treatment of congenital metatarsus varus and evaluate the efficacy of static vs dynamic anti-varus orthosis.

Methods: Twenty-five children (14 males, 11 females), of 81.3 days of age (range 1-189) (41 feet affected) were selected among 88 patients referred to our rehabilitation department for foot deformity. Children were assigned to 1 of 2 groups (dynamic or static orthosis) according to a simple randomization scheme. Patients were evaluated at diagnosis (T1), at the end of treatment (T2) and at a follow-up performed at least 2 years after the end of treatment (T3). Primary outcome was measured using the Bleck scale. The IOWA functional rating system questionnaire was performed at follow up evaluation.

Results: The Bleck scale showed that both static and dynamic orthoses were effective and that the best results were achieved with early treatment. The IOWA questionnaire showed that no child had residual deformities that interfered with daily activities. Nonetheless, the dynamic orthosis group had better scores in 4 sub-items related to parental satisfaction, foot function, heel position, and foot passive motion.

Conclusions: Both static and dynamic orthoses are useful for correction of congenital metatarsus varus. Optimal results are achieved with early treatment.