Metatarsalgia: pathogenesis, biomechanics and surgical treatment

Authors

  • I.M. Zazirnyi Clinical Hospital “Feofaniya” of the Agency of State Affairs, Kyiv, Ukraine,
  • D.R. Blyzniuk-Khodorovskyi Clinical Hospital “Feofaniya” of the Agency of State Affairs, Kyiv, Ukraine,

DOI:

https://doi.org/10.22141/1608-1706.4.21.2020.213063

Keywords:

central metatarsalgia, biomechanical changes, forefoot, surgical treatment

Abstract

Metatarsalgia is the term for pain in the forefoot. This is a set of symptoms corresponding to a wide range of diseases. Central metatarsalgia arises from structural and functional changes that lead to excessive pressure in the area of metatarsal heads. The data analysis demonstrated that presently various types of metatarsal osteotomy are the main surgical treatment options with the risk of complications ranging from 6 to 50 %. Weil osteotomy is known to be the most popular type of osteotomy for the treatment of central metatarsalgia. The most common complication of Weil osteotomy is floating toe, the one that doesn’t contact with the supporting surface. In case of Weil osteotomy and interphalangeal arthrodesis with transarticular fixation performed together, the incidence of floating toe increases up to 50 %. When Weil osteotomy, plantar plate repair, extensor digitorum longus tendon lengthening and removal of the bone wedge (triple Weil osteotomy) are performed simultaneously, the complication rate is approximately 15 % which is much lower. Using combined osteotomy techniques as well as taking into account structural and functional pathologic changes of the forefoot and repair of metatarsophalangeal joint ligaments will ensure the most successful development of surgical treatment techniques for central metatarsalgia.

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Published

2020-08-01

Issue

Section

To General Practitioner