Metatarsalgia

Fig. 30a1. Metatarsalgia: The different aspects.

1. Plantar callosities on the central rays. 2. Central metatarsalgia "round forefoot". 3, 4. Callosities on a single ray. 5. Plantar overpressure on the first ray. 6. Plantar overpressure on the fifth ray. Clinical (7) and pedo-barometric (8) assessment of plantar overpressure. 9, 10, 11. The main radiographic assessment is made on a dorso-plantar view in standing position (9) on a medial oblique view (10), at last on an axial (11) radiography.

Fig. 30a1. Metatarsalgia: The different aspects.

1. Plantar callosities on the central rays. 2. Central metatarsalgia "round forefoot". 3, 4. Callosities on a single ray. 5. Plantar overpressure on the first ray. 6. Plantar overpressure on the fifth ray. Clinical (7) and pedo-barometric (8) assessment of plantar overpressure. 9, 10, 11. The main radiographic assessment is made on a dorso-plantar view in standing position (9) on a medial oblique view (10), at last on an axial (11) radiography.

The term metatarsalgia was used to describe many conditions including metatarsal head pain, forefoot neuroma, intractable plantar keratosis, metatarsal joint instability or dislocation, synovitis and inflammatory or degenerative arthritis of the metatarsophalangeal joint.

In this book, we limit the meaning of metatarsalgia to metatarsal head pain in its plantar aspect, in a standing position. The other aspects of painful MTP joint are described in other chapters.

Metatarsalgia is a frequent patient complaint in first examination for forefoot pathology. It is a complex problem that requires considerable discussion. We therefore elected to divide this chapter into these three subchapters:

1. Study of the causes of metatarsalgia.

2. The surgical procedures we use for relieving metatarsalgia, with their techniques, advantages, limits.

3. Study of the different clinical types and their appropriate surgical treatment.

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