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Observation as the deformity should resolve in time
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Wearing of straight last shoes
Serial stretching and casting for the next 6 to 12 weeks
Heyman, Herndon, and Strong capsular release at the tarsometatarsal and intermetatarsal joints
Berman and Gartland dome-shaped osteotomies of the metatarsal bases
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Weinstein reported on 31 patients (45 feet) with congenital metatarsus adductus followed for an average of 33 years. Twenty-nine feet had moderate to severe deformities treated with manipulation and casting with a 90% success rate. In a young child, surgery is not indicated until nonsurgical management has failed. In patients 2 to 4 years of age, tarsometatarsal capsulotomies are indicated, whereas multiple metatarsal osteotomies are reserved for recalcitrant deformities in children older than 4 years of age. Mild or moderate metatarsus adductus that is passively correctable will resolve without treatment.
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