Which of the following best describes the initial approach to a mild metatarsus adductus in infancy?

• A. Immediate casting
• B. Observation only with no follow-up
• C. Spontaneous correction over time
• D. Urgent surgical correction

Answer: (C)

Mild metatarsus adductus in infancy is often a flexible deformity that tends to improve on its own as the child grows. When the forefoot can be gently abducted to align with the hindfoot, this suggests a flexible, self-limiting issue rather than a fixed one. In this scenario the best initial approach is to observe and reassure the family, with periodic follow-up to ensure the deformity is improving or at least not worsening. Casting or surgical correction is reserved for more persistent, rigid, or severe cases that do not improve with time. Urgent surgery is not appropriate for a mild presentation, and observation alone without follow-up isn’t ideal because you still need to monitor progress. So the favorable course is spontaneous improvement over time with careful observation.