Neonatal metatarsus adductus, joint mobility, axis and rotation of the lower extremity in preterm and term children 0-5 years of age

Abstract

A total of 484 premature children and a control group of 114 healthy term children underwent orthopaedic follow-up from birth to 5 years of age. At birth, metatarsus adductus was found to be more frequent in twins than in single infants (41% vs 16%; P less than 0.01), but occurred with equal frequency in single preterm and term infants (16% vs 12%). By 5 years of age, metatarsus adductus had resolved in all the term but only in 81% of the preterm children (P less than 0.05). In the preterm and term groups, knee axis (mean intermalleolar distance 22.0 mm vs 20.1 mm), tibial torsion (mean angle -1.2 degrees vs + 0.6 degrees) and angle of gait (mean angle + 1.5 degrees vs + 0.7 degrees) at 5 years were statistically insignificant. Hip function at 5 years was similar in normal preterm and term children but significantly decreased in preterm children with cerebral palsy, more so with regard to abduction (56 degrees vs 39 degrees, P less than 0.05) and extension (22 degrees vs 8 degrees, P less than 0.01). The difference between the sexes was insignificant in both the preterm and term groups.