What clinical feature distinguishes metatarsus adductus from congenital clubfoot?

Metatarsus adductus and congenital clubfoot (talipes equinovarus) can present with similar foot positioning in infants, but several clinical features help to differentiate the two conditions. A key distinguishing feature is the position of the hindfoot.

In metatarsus adductus, the hindfoot typically remains in a neutral position, allowing for better passive correction of the forefoot positioning. The forefoot shows medial deviation, but the underlying alignment of the hindfoot is not rigid; it can move freely. This means that, upon examination, the clinician can often correct the forefoot into a more neutral position without much resistance.

In contrast, congenital clubfoot is characterized by a rigid deformity where the foot is characterized by ankle equinus (plantar flexion) and varus (inward position) of the hindfoot. The hindfoot in clubfoot cannot be easily adjusted to a neutral position, indicating underlying anatomical changes versus the positional issues seen in metatarsus adductus.

This distinction is vital in clinical assessments to guide appropriate management and treatment strategies for the infant.