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At least 73 records · Page 4Linked to original sources
PubMed1992

Oblique sliding metatarsal osteotomy for pressure metatarsalgia.

The transverse arch of the foot is formed by metatarsals which heads lie in a straight line to endure most of the loading of the forefoot. Malalignment of one or more metatarsal heads will result in increased loading and produce local tender plantar callosity. The treatment of pressure metatarsalgia must aim for it's pathomechanic cause, that is, hyper-extension of metatarsophalangeal joint. We have modified the distal metatarsal osteotomy to treat 40 toes in 22 cases. Follow up for an average of 21.3 months (ranging from 18 months to 31 months) indicated 19 cases (86.4%) with satisfactory results. The 3 cases with unsatisfied results were all due to early removal of the pin. Maximum oblige sloping of the osteotomy makes the osteotomy slide more easily and ensures union. Intramedullary pinning and early weight bearing maintain the osteotomic alignment, prevent foot stiffness and allow the distal fragment telescopes to be adequately positioned to prevent over correction which leads to transfer lesion. Compared to other methods, modified metatarsal osteotomy is less invasive, preserves natural structure, is easily performed and easy cared for which leads to effective and stable results.

Adult↗
PubMed1990

Soft-tissue causes of metatarsalgia.

A soft-tissue cause should always be considered when evaluating metatarsalgia. The history, examination, and plain radiographs can all suggest an avenue of pursuit, be it a potential dermatologic, connective tissue, vascular, neurologic, muscular, or neoplastic process.

Foot Dermatoses↗
PubMed1990

Lesser metatarsalgia evaluation and treatment.

Anatomic and biomechanical aspects of the complex topic of metatarsalgia are reviewed. Cause is classified as structural, functional, and a combination of both. Evaluation of the lesion symptom complex is presented and light is shed on reasons for complications after metatarsal osteotomy. Ways to avoid complications are also discussed. The oblique osteotomy with rigid fixation performed at the distal surgical neck or the proximal metaphysis is recommended.

Diagnosis, Differential↗
PubMed1990

Lesser metatarsalgia. Rheumatologic considerations.

The differential diagnosis for metatarsalgia should include rheumatoid arthritis, SLE, mixed connective tissue disease, psoriatic arthritis, Reiter's syndrome, fibromyalgic syndrome, gout, post-traumatic joint disease, and septic arthritis. When the patient's symptoms are approached systematically an accurate diagnosis can lead to implementation of an appropriate treatment plan. Multidisciplinary treatment approaches often lead to the most satisfying therapeutic outcomes.

Foot Diseases↗
PubMed1989

[Morton metatarsalgia].

Four cases of Morton's metatarsalgia are presented. In all cases history and clinical findings were typical. The duration of the disease until the assessment of the final diagnosis with an average of three years was very long. Conservative treatment in all cases was unsuccessful, operative excision of the neuroma resulted in complete relief of pain.

Adult↗
PubMed1994

[Morton metatarsalgia. Results of surgical treatment in 54 cases].

This syndrome, which involves nerve compression, is probably often overlooked and is, therefore, more frequent than supposed. It is characterized by pain of the forefoot, especially the 3rd and 4th toe, and is induced by pressure of the intermetatarsal space, or extension of the metatarsophalangeal joints. Results of the present study suggest that it can be successfully treated by surgery. Fifty-four patients--mostly women in midlife--had undergone operation by dorsal excision of the "neuroma" which had been performed under local anaesthesia in a bloodless field. Forty of the patients (74.1%) had recovered completely within an observation period of 1-6 years. Four (7.4%) demonstrated significant, and another 4, only slight improvement. In 6 cases (11.1%), surgery failed. The 6 unsuccessful cases had not exhibited any preoperative disturbance to the sensibility of the 4th toe. They showed, rather, symptoms of conversion disorder with depressive features, e.g. increased nocturnal suffering which is atypical for Morton's metatarsalgia. It is concluded that the accuracy of diagnosis according to strict criteria is decisive for surgical outcome.

Adult↗
PubMed1975

[Rare location of an epidermoid cyst in the forefoot region with nerve compression syndrome. Contribution to the differential diagnosis of Morton's metatarsalgia (author's transl)].

The case of a rare location of an epiderman cyst in the forefoor region is reported. Very intense pain on pressure or tension in the plantar region of the second and third metatarsals suggested a metatarsalgia and the existing diffuse swelling a synovitis. Surgical revision revealed an epidermoid cyst the size of a hazelnut which pressed the N. digitalis plantaris communis against the head of the third metartarsal.

Adult↗
PubMed1993

[Metatarsalgia and modified Helal's operation. Apropos of a series of 40 cases].

The authors report a series of 40 cases of metatarsalgia operated according to a modified Helal technique. The mid-diaphyseal osteotomy was situated obliquely inferoanteriorly at an angle of 45 degrees on the metatarsal diaphysis. Twenty cases of hallux valgus were operated during the same procedure Surgery allowed a reduction in pain and hyperkeratosis in 67.5% of patients. Comparison of the results obtained with those reported in the literature confirms that the osteotomy must be metaphyseal and that weight bearing must be early and effective.

Adult↗
PubMedDate not supplied

The anterior heel for metatarsalgia in the adult foot.

A conservative approach to foot problems is especially useful in patients with diabetes, rheumatoid arthritis, diminished circulatory changes, and those who are too debilitated for surgical treatment. If one will start with either the medial heel wedge or the anterior heel correction, some response should be evident within 4 to 6 weeks. If the response after a trial period of approximately two to three months for a heel wedge or another two to three months for the anterior heel doesn't relieve pain, then perhaps some other problem might now become easier to localize, i.e. Morton's toe syndrome, hallux valgus, soft or hard corns, or hammertoe deformities. When the anterior heel is prescribed many foot problems other than metatarsalgia will stop being symptomatic and surgery treatment can be bypassed. A physician must know about the supply of shoes in the community and, if necessary, instigate a better inventory of available shoes. In addition, it is necessary to establish good rapport with the shoe repair man so that he will not intrude in your patient rapport or alter your directions. Patients also need advice about losing weight. Frequently a loss of 15 or 20 pounds will change a patient's complaint from one of extremely discomforting daily weight-bearing to a tolerance of a fair amount of walking and at least a reduction of the complaints to a more endurable and functional level. One can't expect the shoe correction to do everything for everyone. The anterior heel isn't the whole solution to the complicated problem but it helps to have patients begin to see results in more comfort in their shoe wear.

Adult↗
PubMed1996

Results of excision of the interdigital nerve in the treatment of Morton's metatarsalgia.

Thirty-one patients (thirty-two feet) had excision of the interdigital nerve as treatment of their Morton's metatarsalgia. A longitudinal dorsal incision was used in all cases. Twenty-five out of 32 cases had a macroscopically visible neuroma, and only two had no evidence of a neuroma on histological examination. All thirty-two patients were available for follow-up at an average of 44.7 months (range 14 to 71 months) postoperatively. Eighty-one per cent of the patients had a good or excellent result, 12.5% had a fair result, with residual pain and some restriction of activities, and 6.5% had no improvement after their operation. It is noteworthy that 19 patients (60%) benefitted from wearing adapted shoes or inner soles for a considerable time after the operation. Even at final follow-up, only 10 patients (30%) had no restrictions in the choice of their shoes.

Female↗
PubMed1997

[Static metatarsalgia].

Static metatarsalgia involves pain of non-inflammatory origin in the region of the metatarsal heads. It is caused by a functional disorder or anatomic derangement of the architecture over the ball of the foot, whether congenital or acquired, evident or not. Clinical examination, including of the shoe and of the plantar orthosis, distinguishes five types of anomalies: 1. horizontal malalignment of the metatarsal heads with insufficiency at the first metatarsal-phalangeal joint, dominated by hallux valgus, and involvement of the second metatarsal bone, sometimes favouring Freiberg's disease; 2. vertical malalignment, with a hollow anterior foot, sometimes complicated by Morton's neuroma; 3. a combination of these two anomalies, easily diagnosed but less easily treated; 4. possible enlargement of the first metatarsal-phalangeal joint (hallux rigidus, sesamoid pathology); 5. no patent architectural anomalies, but stress fractures or bone insufficiency fractures of the metatarsals. Only clinical examination can orient complementary strategy and examinations.

Adult↗
PubMed1998

[Sagittal load-bearing tomography of the forefoot and static metatarsalgia].

We describe the use of weight-bearing foot tomograms. The outline of the food is drawn so as the axes of the metatarsal beyond the toes on the AP plain radiogram and the tomograms are done successively on each metatarsal. This morphological, but also functional, analysis enables exact diagnosis of excessive loading on the metatarsal head. This procedure is used in case of metatarsalgia with normal metatarsal length and in late post-traumatic sequellae of the forefoot. Surgical correction can then be precisely performed.

Arthralgia↗
PubMedDate not supplied

[The Weil osteotomy in metatarsalgia].

AIM: The purpose of the prospective study is to evaluate the results of Weil osteotomy in painful overloaded central forefoot with dislocation of the MTP joint. METHOD: 19 left and 16 right feet underwent the Weil osteotomy. In 10 patients the procedure was performed on both feet. In 15 cases only one metatarsal was corrected (the 2 (nd) in 12 and the 3 (rd) in 3 cases), in 17 cases both the 2 (nd) and the 3 (rd) metatarsals and in 4 cases also with the 4 (th) one together. The simultaneous correction of hallux valgus was performed in 19 forefeet. The mean follow-up was 31 months (range, 19 to 41 months). RESULTS: All patients were satisfied with the result of the operation. The results were excellent in 29 cases (83 %) and good in 6 cases (17 %). The plantar callus disappeared in 27 feet (77 %) and decreased in 8 feet (23 %). In one patient the new callus formed under the head of the neighbouring metatarsal bone. The sufficient MTP joint reduction was found in 31 cases (89 %). CONCLUSION: It is possible with the Weil osteotomy to correct the metatarsal length accurately according to the preoperative planning. This results in the prevention of new callus formation under the neighbouring metatarsal head. Stable internal fixation allows the early mobilisation of the MTP joint.

Adult↗