Evaluation of metatarsus adductus

Panel A: Flexibility is determined by whether adduction can be corrected with manipulation back to the normal position. Metatarsus adductus is considered to be flexible if the forefoot can be passively abducted past the midline position, semiflexible if the forefoot can be passively abducted to the midline position (but not past it), and rigid if the forefoot cannot be passively abducted to the midline position.
Panel B: The severity of metatarsus adductus is determined by the position of the heel bisector line (the line that bisects the heel pad and is extended through the toes). The normal heel bisector crosses the second toe or second toe web space. The more severe the deformation, the more lateral the toes that the heel bisector line crosses.