title: Does the parental stretching programs improve metatarsus adductus in newborns?
abstract: Metatarsus adductus (MA) is a common pediatric foot deformity. Current recommendations suggest observation until 4-6 months, then casting if the deformity persists. Based on our review of the literatures, no randomized controlled trial has been conducted to study the effectiveness of parental stretching in the correction of MA in newborn.
  
  
  
  Ninety-four newborn feet that were diagnosed as MA by clinical examination were enrolled. Feet were randomized into two groups: observation group and stretching group. Outcome measurements were performed to compare success rate between groups.
  
  
  
  According to Pearson's χ2test, there were no statistically significant differences between groups with regard to the overall success of the parental stretching program ( p = 0.191). There was also no significant difference between groups for mild degree or moderate-to-severe degree ( p = 0.134, p = 0.274, respectively). A more rapid success rate was observed in the stretching group at the first month follow-up, but rate of improvement then decreased. The stretching group tended to have a lower success rate compared to the observation group in moderate-to-severe feet, but the difference was not statistically significant.
  
  
  
  Parental stretching program found no benefit over observation group in this study. Parental stretching program should not be applied for newborn babies with moderate-to-severe MA as the result from the study appeared to have lower success rate compared to observation group. Observe until 4-6 months, then corrective casting for the persisting deformity is recommended.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Perajit
authors.initials: P
authors.lastname: Eamsobhana
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Karn
authors.initials: K
authors.lastname: Rojjananukulpong
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Thanase
authors.initials: T
authors.lastname: Ariyawatkul
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Chatupon
authors.initials: C
authors.lastname: Chotigavanichaya
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kamolporn
authors.initials: K
authors.lastname: Kaewpornsawan
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D000070592:Metatarsus Varus / Q000628:therapy*; D052580:Muscle Stretching Exercises; D010290:Parents; D013997:Time Factors; D016896:Treatment Outcome
keywords: foot deformity; foot manipulation; metatarsus adductus; stretching program