UNFO is a new orthosis designed to correct and maintain the correction of metatarsus adductus. Thanks to the use of 3 pressure points with the possibility of increasing the pressure gradually over the peak of the deformity from the lateral side, treatment with it gives fantastic results in a short time.

Before using the UNFO orthosis, the child undergoes a full orthopedic and/or physiotherapeutic qualification by a qualified specialist (a list of specialists trained and authorized to qualify the child for the use of the UNFO orthosis in treatment can be found at WEBSITE).

The UNFO orthosis replaces 3 elements of „conservative” therapy that we use in children after 6 months of age: casting, the use of the Mitchell brace or other or foot abduction brace and physiotherapy. The UNFO orthosis focuses on all of this. Its specific structure ensures excellent and quickly noticeable treatment effects.

Treatment with the UNFO orthosis lasts 14-16 weeks and is carried out according to a strict protocol that the patient’s parents receive during qualification for the orthosis. Its use is necessary in the treatment and gives excellent treatment results. Failure to use UNFO according to the protocol leads to a lack of treatment effects and deterioration of the foot condition.

The UNFO orthosis is used according to a specific time protocol. The use of the UNFO orthosis significantly shortens the treatment process (16 weeks vs. 2 years) and reduces its cost: applying plaster casts for correction requires weekly visits to the orthopedic clinic, which entails financial and time costs, and the derotation splint should be used until the age of 2.

The application of the orthosis itself is painless and problem-free for the child and easy for parents to use. It allows for the child’s daily hygiene (normal bathing), easy assessment of the foot skin condition and a quick response to emerging problems that are not large and serious.

In the treatment of forefoot adduction using the conservative method, i.e. plaster casts, the casts are changed every week, and their number depends on the degree of stiffness of the defect and the possibility of achieving passive correction. Depending on the age of the child, we apply two types of casts: a long leg cast (from the toes to the groin with the knee bent at a 90-degree angle, as in the treatment of clubfoot – Ponseti cast) or a short leg cast (from the toes to the knee). Does this cast limit children’s development? Absolutely not! What’s more, children in a cast function properly and find many ways to move. Parents’ concerns about „immobilizing” the child often become unfounded. It is best to end the treatment with plaster casts when the child begins to walk independently. This usually happens around 12-14 months of age. Until then, we undertake treatment with this form of therapy. Why? So as not to limit the child’s movement.

After correcting the forefoot adduction, the Mitchell brace or foot abduction brace is used until the age of 2 for 10-12 hours a day as a crucial piece of equipment to maintain foot correction. Many parents may think that the foot abduction brace will limit their children and be a burden for them. We firmly deny these concerns – if the FAB (foot abduction brace) is well-fitted and set, it does not cause the child any problems in using it. It also does not cause motor delays, because it is usually used during night sleep (minimum 10 hours in a row) + during daytime naps. If the child does not sleep during the day, 10 hours is the minimum period of its use, which usually ensures night sleep.

The cast must be applied by a qualified team of specialists, including an pediatric orthopedic doctor and a cast technician. Only such a combination gives correct results in treatment. Casting by an inexperienced team can result in complications in the form of skin and nerve damage and the creation of additional deformations if the cast is applied too tightly and incorrectly.

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Studies:
1. Bleck E.: „Metatarsus adductus: Classification and Relationship to outcomes of treatment” (1983)
2. Hunziker U.A. et al.: „Neonatal metatarsus adductus, joint mobility, axis and rotation of the lower extremity in preterm and term children 0-5 years of age.” (1988)
3. Castellano B. et al.: „Metatarsus adductus.”
4. Marshall N. et al.: „The identification and appraisal of assessment tools used to evaluate metatarsus adductus: a systematic review of their measurement properties.”
5. Wan S. C.: „Metatarsus adductus and skewfoot deformity.”
6. Herzenberg E. J. et al.: „Resistand metatarsus adductus: prospective randomized trial of casting versus orthosis.”
7. Agnew P.S.: „Metatarsus adductus (Midfoot Adduction).”
8. Li Y. et al.: „Reverse-shoe wearing method for treating toe-in gait in children can lead to hallux valgus.”
9. Panski A. et al.: „Universal neonatal foot orthotics – a novel treatment of infantile metatarsus adductus.”
10. Freedman D. et al.: „Novel device for nonsurgical correction of rigid forefoot adduction in children.”

Photos:
1. Filip Mroz
2. UNFO: own
3. Cast: own
4. Mitchell boots and brace: own
5. Photo by AYOUB AALLAGUI on Unsplash
6. Shoes