The hypothesis that the treatment of adduction of the fore part of the
foot in the child is altered by an associated deformity of the middle or
the hind part, or both, was tested in a prospective study of eighty-four
patients (124 feet). Radiographic classification delineated four
configurations of adduction of the foot, based on varying relationships of
the fore, middle, and hind parts of the foot. Twenty-two (43 per cent) of
the feet with adduction of the fore part alone (simple metatarsus adductus)
required no treatment, as compared with eighteen feet (24 per cent) with
the other types of adduction (p less than 0.03). The patients with a
complex skew-foot deformity required twice as long a period of cast
treatment as those with simple metatarsus adductus (p = 0.0001). On
evaluation at a minimum follow-up of two years, only one of the 124 feet
had residual adduction of the fore part of the foot, as determined
radiographically. It was also found that the use of the Denis-Browne bar
was accompanied by an increased incidence of flat-foot deformity at
follow-up.