865 results match your criteria Metatarsalgia


The effectiveness of shoe modifications and orthotics in the conservative treatment of Civinini-Morton syndrome: state of art.

Acta Biomed 2020 May 30;91(4-S):60-68. Epub 2020 May 30.

Orthopaedic Clinic, Department of Surgical Sciences (DISC), University of Genoa, Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.

Civinini Morton's Syndrome (CMS), better known as Morton's Neuroma, is a benign enlargement that typically affects the third common digital branch of the plantar nerve. It is a common cause of metatarsalgia leading to debilitating pain. It prefers the female gender, with a female to male ratio of 5:1 and an average age of 50 years at time of surgery. Read More

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http://dx.doi.org/10.23750/abm.v91i4-S.9713DOI Listing

Radiographic Impact of Lapidus, Proximal Lateral Closing Wedge Osteotomy, and Suture Button Procedures on First Ray Length and Dorsiflexion for Hallux Valgus.

Foot Ankle Int 2020 Jun 9:1071100720925438. Epub 2020 Jun 9.

Rush University Medical Center, Midwest Orthopedics at Rush, Chicago, IL, USA.

Background: Shortening and dorsiflexion of the first metatarsal are known potential side effects of metatarsal osteotomies for hallux valgus (HV) with the potential to cause transfer metatarsalgia. We compared the effect of the first tarsometatarsal joint arthrodesis (Lapidus procedure), proximal lateral closing wedge osteotomy (PLCWO), and intermetatarsal suture button fixation procedures on the length and dorsiflexion of the first ray.

Methods: We retrospectively evaluated 105 feet in 99 patients with 30 weeks of follow-up. Read More

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http://dx.doi.org/10.1177/1071100720925438DOI Listing

Synthetic Cartilage Implant Hemiarthroplasty for Second MTP Joint Osteoarthrosis.

J Foot Ankle Surg 2020 Jun 3. Epub 2020 Jun 3.

Podiatric Surgical Trainee, Department of Podiatric Surgery, Ilkeston Hospital, Derbyshire, England.

Synthetic cartilage hemiarthroplasty has been used successfully in the first metatarsophalangeal (MTP) joint and might also provide an alternative surgical intervention for second MTP joint osteoarthritis and Freiberg disease. Synthetic cartilage implant hemiarthroplasty was performed on 23 consecutive patients for the treatment of painful second MTP joint disease. Joint damage ranged from mild to severe. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.08.035DOI Listing

Radiographic Assessment of Relative First Metatarsal Length Following Modified Lapidus Procedure.

Foot Ankle Int 2020 May 27:1071100720924016. Epub 2020 May 27.

The Orthopaedic Foot and Ankle Unit, Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa.

Background: The modified Lapidus is a surgical procedure for managing moderate to severe hallux valgus, especially in the presence of first tarsometatarsal joint arthritis or hypermobility. It has good long-term results but reportedly can lead to transfer metatarsalgia due to inherent shortening of the first metatarsal.

Methods: A retrospective analysis of all adult patients who underwent a modified Lapidus procedure during a 3-year period was performed. Read More

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http://dx.doi.org/10.1177/1071100720924016DOI Listing

Influences of high-heeled shoe parameters on gait cycle, center of pressure trajectory, and plantar pressure in young females during treadmill walking.

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020921978

Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.

Purpose: This study aimed to investigate the influences of high-heeled shoe (HHS) parameters on gait cycle, center of pressure (COP) trajectory, and plantar pressure in young females.

Methods: Twenty healthy adult females were recruited to participate in this study. Subjects walked on a treadmill at a fixed speed (1 m/s). Read More

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http://dx.doi.org/10.1177/2309499020921978DOI Listing

First Metatarsophalangeal Joint Arthrodesis Using Memory Staples: Clinical and Functional Results.

Foot Ankle Spec 2020 May 11:1938640020921573. Epub 2020 May 11.

Department of Trauma and Orthopaedics, Dumfries and Galloway Royal Infirmary, Dumfries, United Kingdom.

We present clinical and functional results of first metatarsophalangeal joint (MTPJ) arthrodesis using Memory staples. This retrospective observational study reviewed MTPJ arthrodesis with Memory staples from 2012 to 2016. The mean age of 50 patients (55 feet) was 63 years (range 41-77 years). Read More

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http://dx.doi.org/10.1177/1938640020921573DOI Listing

Distal chevron osteotomy with lateral release for moderate to severe hallux valgus patients aged sixty years and over.

Int Orthop 2020 Jun 23;44(6):1099-1105. Epub 2020 Apr 23.

Department of Orthopaedic Surgery, Asan Medical Center, Seoul, South Korea.

Purpose: To analyze the outcome of distal chevron metatarsal osteotomy (DCMO) with lateral release for moderate to severe hallux valgus patients aged 60 years or more.

Methods: Consecutive 77 DCMOs in 54 patients were evaluated. Average age at operation was 65. Read More

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http://dx.doi.org/10.1007/s00264-020-04562-5DOI Listing

Lesser Metatarsophalangeal Instability: Diagnosis and Conservative Management of a Common Cause of Metatarsalgia.

Sports Health 2020 Jul/Aug;12(4):390-394. Epub 2020 Mar 30.

Baptist Health South Florida, Miami, Florida.

Context: Lesser metatarsophalangeal (MTP) instability is a common condition that can become debilitating and require surgery.

Evidence Acquisition: An extensive literature review was performed through MEDLINE and Google Scholar for publications relating to the etiology, diagnosis, and treatment of lesser MTP instability using the keywords , and from database inception to 2019.

Study Design: Clinical review. Read More

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http://dx.doi.org/10.1177/1941738120904944DOI Listing

Comparison of Combination Weil Metatarsal Osteotomy and Direct Plantar Plate Repair Versus Weil Metatarsal Osteotomy Alone for Forefoot Metatarsalgia.

J Foot Ankle Surg 2020 Mar - Apr;59(2):303-306

CEO, Weil Foot and Ankle Institute, Mount Prospect, IL.

Although many surgeons believe that shortening osteotomies are appropriate in patients with metatarsalgia and long second metatarsals, there remains ambiguity regarding when to repair the injured plantar plate and when to leave it alone. We prospectively assessed consecutive adult subjects who underwent an isolated second Weil metatarsal osteotomy (WMO) or a WMO plus plantar plate repair (WMO + PPR) for sub-second metatarsophalangeal joint pain during a 3.5-year period at our practice. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.08.023DOI Listing

MIS Distal Metatarsal Metaphyseal Osteotomy in the treatment of metatarsalgia: MOXFQ patient reported outcomes.

Foot (Edinb) 2020 Jun 24;43:101661. Epub 2020 Jan 24.

NHS Lothian, United Kingdom.

Introduction: The aim of this paper is to present validated patient reported outcomes for MIS Distal Metatarsal Metaphyseal Osteotomy (DMMO) in the treatment of metatarsalgia. The study aims to evaluate the DMMO procedure, report patient satisfaction with the operated foot and report any complications of this procedure.

Patients And Methods: Between 2014 and 2016, patients who had failed conservative treatment for metatarsalgia were identified in the orthopaedic outpatient clinic. Read More

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http://dx.doi.org/10.1016/j.foot.2019.101661DOI Listing

Improved Injection Technique of Ethanol for Morton's Neuroma.

Foot Ankle Int 2020 May 4;41(5):590-595. Epub 2020 Feb 4.

Clinica Ortopedica e Traumatologica, Università di Verona, C.O.C. G.B. Rossi, Verona, Italy.

Background: Morton's neuroma is a common cause of forefoot pain. Various conservative methods (injections of various pharmacologic agents) have been published with an outcome of 6%-75% success rate (free of pain in daily life) per injection. The aim of the present study was to assess the outcome of an improved localization technique, a higher dosage, and a higher percentage of ethanol. Read More

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http://dx.doi.org/10.1177/1071100720903096DOI Listing

Silastic first metatarsophalangeal joint arthroplasty for the treatment of end-stage hallux rigidus.

Bone Joint J 2020 Feb;102-B(2):220-226

Wrightington and Leigh NHS Foundation Trust, Wrightington Hospital, Wigan, UK.

Aims: Arthroplasty for end-stage hallux rigidus (HR) is controversial. Arthrodesis remains the gold standard for surgical treatment, although is not without its complications, with rates of up to 10% for nonunion, 14% for reoperation and 10% for metatarsalgia. The aim of this study was to analyze the outcome of a double-stemmed silastic implant (Wright-Medical, Memphis, Tennessee, USA) for patients with end-stage HR. Read More

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http://dx.doi.org/10.1302/0301-620X.102B2.BJJ-2019-0518.R2DOI Listing
February 2020

Complications after Metatarsal Osteotomies for Hallux Valgus: Malunion, Nonunion, Avascular Necrosis, and Metatarsophalangeal Osteoarthritis.

Foot Ankle Clin 2020 Mar 26;25(1):169-182. Epub 2019 Nov 26.

Foot and Ankle Service, Department of Orthopedic Surgery, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, Piso 3, Santiago 8330077, Chile.

Avascular necrosis (AVN), nonunion, malunion, and metatarsophalangeal (MTP) osteoarthritis following hallux valgus osteotomies, as well as pathophysiology, diagnosis, prevention strategies, and treatment are discussed in this article. AVN and nonunion are very infrequent, and they can be effectively prevented taking into consideration local anatomy preservation, biomechanics, and patient comorbidities. Shortening, elevation, plantarflexion, varus/valgus, and rotational of the first metatarsal are the most common types of malunion. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.10.008DOI Listing

Management of Complications After Hallux Valgus Reconstruction.

Foot Ankle Clin 2020 Mar 29;25(1):151-167. Epub 2019 Nov 29.

Orthopaedic Foot and Ankle Unit, Orthopaedic and Trauma Department, Hospital Universitario Quironsalud Madrid, Calle Diego de Velázquez 1, Madrid 28223, Spain; Faculty of Medicine, UEM Madrid, Madrid, Spain.

Complications following hallux valgus (HV) reconstruction will have an expected incidence of between 10% and 55% of cases. The more commonly reported complications include undercorrection/recurrence, overcorrection (hallux varus), transfer metatarsalgia, nonunion, malunion, avascular necrosis, arthritis, hardware removal, nerve injury, and ultimately patient dissatisfaction. The presence of arthritis will be an indication for fusion, whereas osteotomies will be the procedure of choice if the first metatarsophalangeal joint is healthy. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.10.011DOI Listing

Tips, quips and pearls: Ultrasound-guided distal metatarsal minimal invasive osteotomy (US-DMMO).

Foot Ankle Surg 2020 Jan 17. Epub 2020 Jan 17.

Department of Orthopaedics and Traumatology, Hospital General Universitario Gregorio Marañón, Calle del Dr. Esquerdo, 28007 Madrid, Spain.

Metatarsalgia is a frequent cause of forefoot pain. Surgical treatment is based on the performance of osteotomies at the level of the minor radii to restore a normal distribution of pressure within the forefoot and improve the biomechanics during gait. In recent years, percutaneous surgery of the foot, and specifically distal metatarsal minimal invasive osteotomy, have proven to be a valid technique, providing satisfactory clinical results, similar to open osteotomy with less soft tissue aggression, but it requires intraoperative fluoroscopy to be performed. Read More

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http://dx.doi.org/10.1016/j.fas.2020.01.004DOI Listing
January 2020

Scarf osteotomy for hallux valgus deformity: Radiological outcome, metatarsal length and early complications in 118 feet.

Foot Ankle Surg 2020 Jan 9. Epub 2020 Jan 9.

Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland.

Background: Scarf osteotomy has been widely used to restore axial orientation of the first ray in the treatment of hallux valgus deformity. The aim of the study was to present our radiological outcomes of bunion reconstruction, identify surgical complications in early follow-up, and assess to what extent a shortening of the first metatarsal is present after surgery as a possible cause of postoperative metatarsalgia.

Methods: We enrolled 106 patients (118 feet) and assessed patients' pre- and postoperative measurements of hallux valgus and intermetatarsal angles on weightbearing X-ray images. Read More

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http://dx.doi.org/10.1016/j.fas.2020.01.002DOI Listing
January 2020

[Effectiveness of double metatarsal osteotomy for severe hallux valgus with increased distal metatarsal articular angle].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Jan;34(1):41-45

Department of Foot and Ankle Surgery, Honghui Hospital Affiliated to Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710054,

Objective: To summarize the technique and effectiveness of double metatarsal osteotomy for treating severe hallux valgus with increased distal metatarsal articular angle (DMAA).

Methods: Between June 2014 and December 2017, 64 patients (94 feet) of severe hallux valgus with an increased DMAA were treated with the double metatarsal osteotomy (distal metatarsal Reverdin osteotomy+proximal metatarsal open wedge osteotomy) combined with Akin osteotomy and soft tissue surgery to correct the deformity. There were 10 males (15 feet) and 54 females (79 feet) with an average age of 44. Read More

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http://dx.doi.org/10.7507/1002-1892.201906062DOI Listing
January 2020

[Short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy for hallux valgus with moderate and severe metatarsus adductus].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Jan;34(1):37-40

Department of Foot and Ankle Surgery, Honghui Hospital Affiliated to Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710054,

Objective: To evaluate the short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy in treatment of hallux valgus with moderate and severe metatarsus adductus.

Methods: Between February 2012 and September 2016, 10 patients (12 feet) of hallux valgus with moderate and severe metatarsus adductus were admitted and treated with the first ray tri-plane osteotomy and other metatarsal basal osteotomy and lateral soft tissue release. There were 1 male (2 feet) and 9 females (10 feet) with an average age of 34. Read More

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http://dx.doi.org/10.7507/1002-1892.201906102DOI Listing
January 2020

Impact of first metatarsal shortening on forefoot loading pattern: a finite element model study.

BMC Musculoskelet Disord 2019 Dec 27;20(1):625. Epub 2019 Dec 27.

Department of Orthopedics, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Rd., Jing'an District, Shanghai, China.

Backgrounds: There has long been a consensus that shortening of the first metatarsal during hallux valgus reconstruction could lead to postoperative transfer metatarsalgia. However, appropriate shortening is sometimes beneficial for correcting severe deformities or relieving stiff joints. This study is to investigate, from the biomechanical perspective, whether and how much shortening of the first metatarsal could be allowed. Read More

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http://dx.doi.org/10.1186/s12891-019-2973-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933751PMC
December 2019
1.898 Impact Factor

Plantar vein thrombosis provoked by mechanical strain to the foot: a rare cause of plantar heel pain.

BMJ Case Rep 2019 Nov 26;12(11). Epub 2019 Nov 26.

Orthopaedics, Haaglanden Medisch Centrum Antoniushove, Leidschendam, The Netherlands.

A 61-year-old mountain hiker presented with acute pain of the medial-plantar aspect of the right foot. As the location, intensity and acute onset of the pain were atypical for fasciitis plantaris, an ultrasound was performed. This demonstrated a segmental plantar vein thrombosis (PVT), which was confirmed on consequent MRI. Read More

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http://dx.doi.org/10.1136/bcr-2019-230054DOI Listing
November 2019

The plantarward oblique Chevron osteotomy: an optional method to treat hallux valgus with painful plantar callosities.

Sci Rep 2019 11 22;9(1):17364. Epub 2019 Nov 22.

Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, P.R. China.

Hallux valgus (HV) is a foot deformity that can be treated with Chevron osteotomy, and a modified plantarward oblique osteotomy has been proposed in recent years. However, no research has focused on the correctional power of the osteotomy. The aim of this study was to examine the character of this plantarward oblique Chevron osteotomy (POCO) and to determine the rationale of this method. Read More

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http://dx.doi.org/10.1038/s41598-019-53479-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6874594PMC
November 2019
5.078 Impact Factor

Ultrasound examination of intrinsic foot muscles in patients with 1st metatarsophalangeal joint arthrodesis.

Foot (Edinb) 2019 Dec 3;41:79-84. Epub 2019 Sep 3.

Department of Kinesiology, University of Virginia, Charlottesville, VA, United States.

1st MTP arthrodesis often alleviates pain in osteoarthritis of hallux, long term outcomes vary, yet there is little known about potentially modifiable changes in the small muscles of the foot and hallux. This study was performed to determine the changes in the size of the Intrinsic Foot Muscles (IFMs) after the arthrodesis of the 1st metatarsophalangeal (MTP) joint by comparing the cross-sectional area (CSA) and muscle thickness (MT) of Abductor Hallucis (AbH), Flexor Digitorum Brevis (FDB) and Flexor Hallucis Brevis (FHB) between surgical and non-surgical feet. A convenience sample of 18 feet of 9 subjects (age: 57. Read More

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http://dx.doi.org/10.1016/j.foot.2019.08.009DOI Listing
December 2019

Constitutional risk factors for focal neuropathies in patients referred for electromyography.

Eur J Neurol 2020 Mar 29;27(3):529-535. Epub 2019 Nov 29.

Department of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.

Background And Purpose: It is well established that patient-related constitutional features predispose to focal peripheral neuropathies. Some of these risk factors were investigated in common focal neuropathies encountered in patients referred for electromyography.

Methods: Gender, age, height and body mass index (BMI) were analysed retrospectively as risk factors for 11 focal neuropathies. Read More

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http://dx.doi.org/10.1111/ene.14118DOI Listing
March 2020
2 Reads

Forefoot Pain in the Lesser Toes: Anatomical Considerations and Magnetic Resonance Imaging Findings.

Can Assoc Radiol J 2019 Nov;70(4):408-415

Department of Radiology, UZ Brussel, Brussels, Belgium. Electronic address:

Various conditions may result in forefoot pain. Magnetic resonance (MR) imaging allows accurate assessment of many of these conditions. We provide an overview of forefoot disorders divided into bones, capsule and plantar plate, musculotendinous structures, neurovascular structures, and subcutaneous tissue. Read More

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http://dx.doi.org/10.1016/j.carj.2019.06.010DOI Listing
November 2019

Introduction the revolving scarf osteotomy for treating severe hallux valgus with an increased distal metatarsal articular angle: a retrospective cohort study.

BMC Musculoskelet Disord 2019 Nov 3;20(1):508. Epub 2019 Nov 3.

Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University, 710054, Xi'an, Shan'xi Province, China.

Background: Hallux valgus(HV) with an increased distal metatarsal articular angle (DMAA) is one of the most common foot deformities among adults. Double metatarsal osteotomy (DMO) is effective in treating severe HV deformity with an increased DMAA. However, this technique presents the risk of avascular necrosis (AVN) of the metatarsal head and transfer metatarsalgia due to shortening of the first metatarsal. Read More

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http://dx.doi.org/10.1186/s12891-019-2874-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825719PMC
November 2019

Current Concepts of Treatment of Metatarsalgia.

Foot Ankle Clin 2019 Dec;24(4):xiii-xiv

Department of Foot and Ankle Surgery, J Slullitel Institute of Orthopedics, San Luis 2534, Rosario 2000, Santa Fe, Argentina. Electronic address:

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http://dx.doi.org/10.1016/j.fcl.2019.09.001DOI Listing
December 2019

Resection Arthroplasty: Current Indications and Tips.

Foot Ankle Clin 2019 Dec 17;24(4):689-693. Epub 2019 Sep 17.

Mount Sinai West, NYC, 425 West 59th Street 5th Floor, New York, NY 10019, USA; Leni & Peter W. May Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

Resection arthroplasty for metatarsalgia is a selective procedure primarily indicated for patients with rheumatoid arthritis. These patients present with significant forefoot deformities, poor bone quality, and loss of soft tissue integrity. Resection of the metatarsal heads and correction of lesser toe deformities improve pain and decrease transfer metatarsalgia. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.005DOI Listing
December 2019
1 Read

Brachymetatarsia: One-stage Versus Two-Stage Procedures.

Foot Ankle Clin 2019 Dec 8;24(4):677-687. Epub 2019 Oct 8.

CALO - Centro de Alongamento Ósseo, Rio de Janeiro, Brazil.

Brachymetatarsia is a rare deformity with controversial clinical presentation. Multiple acute and gradual lengthening surgical techniques have been described for correction of this type of foot deformity. All techniques try to create a better appearance, facilitate shoeing, or solve possible transfer metatarsalgia. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.010DOI Listing
December 2019
2 Reads

Metatarsalgia in Metatarsus Adductus Patients: A Rational Approach.

Foot Ankle Clin 2019 Dec 25;24(4):657-667. Epub 2019 Sep 25.

University of Miami Miller School of Medicine, 900 Northwest 17th Street, Suite 10A, Miami, FL 33131, USA.

Metatarsus adductus (MA) is a congenital condition resulting in adduction of the forefoot at the tarsometatarsal joint, medial metatarsal deviation, supination of the hindfoot through the subtalar joint, and plantarflexed first ray. The exact underlying pathophysiology remains elusive. There is increasing evidence highlighting the importance of recognizing MA as an associated deformity that complicates management of hallux valgus (HV). Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.002DOI Listing
December 2019
0.844 Impact Factor

Gastrocnemius Recession in the Setting of Metatarsalgia: The Baumann Procedure.

Foot Ankle Clin 2019 Dec 17;24(4):649-655. Epub 2019 Sep 17.

Department of Foot and Ankle Surgery, J Slullitel Institute of Orthopedics, San Luis 2534, Rosario 2000, Santa Fe, Argentina.

A fundamental etiologic component of metatarsalgia is the repetitive loading of a locally concentrated force in the forefoot during gait. In the setting of an isolated gastrocnemius contracture, weight-bearing pressure is shifted toward the forefoot. If metatarsalgia is considered an entity more than a symptom, evaluation of gastrocnemius contracture must be a part of the physical examination, and gastrocnemius recession via the Baumann procedure alone, or in combination with other procedures, considered as an alternative treatment in an attempt to restore normal foot biomechanics. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.003DOI Listing
December 2019
1 Read

The Role of First Ray Insufficiency in the Development of Metatarsalgia.

Foot Ankle Clin 2019 Dec 5;24(4):641-648. Epub 2019 Sep 5.

Congress Orthopedic Associates, 800 South Raymond, 2nd Floor, Pasadena, CA 91105, USA; Foot and Ankle Surgery, UCLA Harbor Medical Center, 1000 W Carson Street, Torrance, CA 90502, USA.

Two theories exist in the development of central or transfer metatarsalgia. First, as the severity of hallux valgus increases, there is mechanical overload of the second metatarsal. Second, increased relative lesser metatarsal length is thought to contribute to metatarsalgia. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.07.001DOI Listing
December 2019

Distal Minimally Invasive Metatarsal Osteotomy ("DMMO" Procedure).

Foot Ankle Clin 2019 Dec;24(4):615-625

Spire Cardiff Hospital, Croescadarn Road, Cardiff, Wales CF 23 8XL, UK. Electronic address:

The use of a Shannon burr facilitates an osteotomy of the lesser metatarsals without requiring an open approach to the metatarsal. The end result that is aimed for is the same as for open surgery and therefore care needs to be taken to perform the bone cut in the appropriate manner. A description is provided of the surgical technique for distal minimally invasive osteotomy and its newer modifications-the distal intracapsular minimally invasive osteotomy and the distal oblique metatarsal osteotomy. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.011DOI Listing
December 2019
4 Reads

Evolution of the Weil Osteotomy: The Triple Osteotomy.

Foot Ankle Clin 2019 Dec 8;24(4):599-614. Epub 2019 Oct 8.

Orthopaedica Foot and Ankle Unit, Complejo Hospitalario La Mancha Centro, Av de la Constitución 3, 13600, Alcázar de San Juan, Ciudad Real, Spain.

Weil osteotomy (WO) is the most common technique worldwide for the treatment of mechanical metatarsalgia. The main indication for WO is propulsive/third rocker metatarsalgia that is in relation with an abnormal length of a certain metatarsal with respect to the neighboring metatarsals in the frontal plane. Most clinical studies have showed good to excellent results after WO. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.009DOI Listing
December 2019
1 Read

Scientific Evidence in the Treatment of Metatarsalgia.

Foot Ankle Clin 2019 Dec;24(4):585-598

Institute for Foot and Ankle Reconstruction, FussInsitut Zurich, Kappelistrasse 7, Zurich 8002, Switzerland. Electronic address:

Metatarsalgia is a common foot disease with a multitude of causes. Proper identification of underlying diseases is mandatory to formulate an adequate treatment. Multiple surgical solutions are available to treat metatarsalgia. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.001DOI Listing
December 2019
2 Reads

Mechanical Basis of Metatarsalgia.

Foot Ankle Clin 2019 Dec 8;24(4):571-584. Epub 2019 Oct 8.

Orthopaedic Foot and Ankle Unit, Orthopaedic and Trauma Department, Hospital Universitario Quirónsalud Madrid, Faculty Medicine UEM, Calle Diego de Velázquez 1, Pozuelo de Alarcón, Madrid 28223, Spain. Electronic address:

The 3-rocker mechanism of gait provides a framework to understand why patients have mechanical metatarsal pain and to differentiate between the various types of metatarsalgia. Clinical examination of the patient together with radiological findings allows identification of the type of metatarsalgia and the pathomechanics involved, and the planning of surgical treatment. Second-rocker/nonpropulsive metatarsalgia is related with an abnormal inclination of a metatarsal in the sagittal plane, either anatomic or functional (equinism). Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.008DOI Listing
December 2019
1 Read

Metatarsalgia: Assessment Algorithm and Decision Making.

Foot Ankle Clin 2019 Dec 25;24(4):561-569. Epub 2019 Sep 25.

Department of Foot and Ankle Surgery, J Slullitel Institute of Orthopaedics, San Luis 2534, Rosario 2000, Santa Fe, Argentina.

Historically, metatarsalgia was approached as a forefoot condition, most often associated with hallux valgus. Consequently, surgical treatments were limited to that anatomic zone, disregarding more proximal structures. In order to assess this entity properly, it is necessary to consider anatomic and biomechanical factors, as well as general and local conditions of the affected patients. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.006DOI Listing
December 2019

Treatment of metatarsalgia based on claw toe deformity through soft tissue release of the metatarsophalangeal joint and resection of the proximal interphalangeal joint: Evaluation based on foot kinematics and plantar pressure distribution.

Foot Ankle Surg 2019 Sep 27. Epub 2019 Sep 27.

Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands.

Introduction: This study investigated the effect of operative claw toe correction with release of the metatarsophalangeal (MTP) joint, repositioning of the plantar fat pad and resection of the proximal interphalangeal joint on foot kinematics, plantar pressure distribution and Foot Function Index (FFI).

Methods: Prospective experimental study with pretest-posttest design. The plantar pressure, 3D foot kinematics and the FFI of 15 patients with symptomatic claw toes were measured three months before and 12months after surgery. Read More

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http://dx.doi.org/10.1016/j.fas.2019.09.003DOI Listing
September 2019

Forefoot disorders and conservative treatment.

Yeungnam Univ J Med 2019 05 14;36(2):92-98. Epub 2019 May 14.

Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea.

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Read More

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http://dx.doi.org/10.12701/yujm.2019.00185DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784640PMC
May 2019
1 Read

The Modified Subcapital Metatarsal Osteotomy in the Treatment of Hallux Valgus Recurrence.

Foot Ankle Spec 2019 Oct 4:1938640019875322. Epub 2019 Oct 4.

"Ars Medica" Clinic via Cesare Ferrero di Cambiano, Rome, Italy (AS).

The purpose of the present study is to illustrate the use of a modified subcapital metatarsal osteotomy (MSMO) in the treatment of hallux valgus (HV) recurrence. The article reports the clinical and radiological outcomes of a cohort of 52 consecutive patients presenting with recurrent HV, treated with MSMO. A total of 52 patients (54 feet) underwent operations between May 2010 and November 2015. Read More

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http://dx.doi.org/10.1177/1938640019875322DOI Listing
October 2019
1 Read

First tarsometatarsal fusion using saw preparation vs. standard preparation of the joint: A cadaver study.

Foot Ankle Surg 2019 Sep 13. Epub 2019 Sep 13.

Department of Orthopaedic Surgery, University of Alabama, 1313 13th Street South, Birmingham, AL 35205, USA. Electronic address:

Background: First tarsometatarsal (TMT) joint fusion is effective for treatment of arthritis and some first ray deformities. To prepare the articular surfaces, cartilage should be carefully but completely denuded. Inadequate preparation may result in non-union, while excessive preparation may cause ray shortening and consequential transfer metatarsalgia. Read More

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http://dx.doi.org/10.1016/j.fas.2019.08.016DOI Listing
September 2019
2 Reads

Effectiveness of customized insoles in patients with Morton's neuroma: a randomized, controlled, double-blind clinical trial.

Clin Rehabil 2019 Dec 11;33(12):1898-1907. Epub 2019 Sep 11.

Escola Paulista de Medicina (EPM), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil.

Objective: To assess the effectiveness of customized insole in patients with Morton's neuroma.

Design: Double-blind randomized controlled trial with intent-to-treat analysis.

Setting: Outpatients, University Hospital. Read More

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http://dx.doi.org/10.1177/0269215519873949DOI Listing
December 2019
1 Read

Ultrasound-guided radiofrequency ablation for treatment of Morton's neuroma: initial experience.

Clin Radiol 2019 Oct 10;74(10):815.e9-815.e13. Epub 2019 Aug 10.

Department of Radiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2WB, UK. Electronic address:

Aim: To assess the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for treatment of symptomatic Morton's neuroma.

Materials And Methods: Patients with symptomatic Morton's neuroma of the foot were referred for treatment with RFA, prior to consideration for surgery. All neuromas were proven by ultrasound imaging and had a trial of conservative management including orthotic support and/or steroid injections. Read More

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http://dx.doi.org/10.1016/j.crad.2019.07.002DOI Listing
October 2019
1 Read

Novel Investigation of the Deep Band of the Lateral Plantar Aponeurosis and Its Relationship With the Lateral Plantar Nerve.

Foot Ankle Int 2019 Nov 6;40(11):1325-1330. Epub 2019 Aug 6.

Center for Anatomical Sciences, University of North Texas Health Science Center, Fort Worth, TX, USA.

Background: We describe a thick fascial band arising from the medial aspect of the lateral plantar aponeurosis diving deep into the forefoot crossing over a branch of the lateral plantar nerve. Because a review of current literature resulted in limited and outdated sources, we sought to first determine the frequency of this fascial band and the location where it crosses the lateral plantar nerve and, second, discuss the clinical applications these anatomical findings could have.

Methods: 50 pairs of cadaveric feet (n = 100) were dissected to investigate for presence of the fascial band and its interaction with the lateral plantar nerve. Read More

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http://dx.doi.org/10.1177/1071100719864352DOI Listing
November 2019
2 Reads

Intermetatarsal bursitis as first disease manifestation in different rheumatological disorders and related MR-imaging findings.

Rheumatol Int 2019 Dec 18;39(12):2129-2136. Epub 2019 Jul 18.

Department of Radiology, Eberhard Karls University Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.

Metatarsalgia defined as pain at the plantar aspect of the forefoot. Intermetatarsal bursitis is considered one potential soft-tissue cause of metatarsalgia that is presumably under-estimated, under-investigated, and, consequently, often misdiagnosed. To assess the role of MRI in the elucidation of the cause of metatarsalgia in patients with different autoimmune disorders presenting primarily with this symptom and to present the accompanying clinical and radiological findings of intermetatarsal bursitis. Read More

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http://dx.doi.org/10.1007/s00296-019-04381-xDOI Listing
December 2019
6 Reads

Bunionette deformity corrected with "shortening" scarf osteotomy of the fifth metatarsal: mid-term results of a 34-cases.

Foot Ankle Surg 2019 Jun 19. Epub 2019 Jun 19.

Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic; University Department of Orthopaedic Surgery, University Hospital Martin, Kollarova 2, Martin, 036 59, Slovak Republic.

Background: The aim of this study was to evaluate the clinical and radiological outcomes (in mid-term) after "shortening" scarf osteotomy of the fifth metatarsal for the treatment of bunionette deformity.

Methods: We retrospectively reviewed the functional score - American Orthopaedic Foot and Ankle Society (AOFAS) Lesser Toe Metatarsophalangeal-Interphalangeal Scale, radiographic results - 4th/5th intermetatarsal angle, varus angle of the 5th metatarsophalangeal joint and complications in a consecutive series of 34 feet (27 patients) with bunionette. Nine males and 18 females (mean age: 45 years) were included in the study. Read More

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http://dx.doi.org/10.1016/j.fas.2019.06.001DOI Listing
June 2019
5 Reads

Man with foot pain.

Emerg Med J 2019 Jun;36(6):363-381

Emergency Department, Maine Medical Center, Portland, Maine, USA.

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http://dx.doi.org/10.1136/emermed-2018-208150DOI Listing
June 2019
1 Read

Mechanical diagnosis and therapy and Morton's neuroma: a case-series.

J Man Manip Ther 2020 Feb 9;28(1):60-67. Epub 2019 Jun 9.

Maccio Physical Therapy, Troy, NY, USA.

: Morton's neuroma (MN) is a neuralgia involving the common plantar digital nerves of the metatarsal region. Evidence-based treatment options for MN are sparse, and utility of physical therapy (PT) is unknown. Mechanical Diagnosis and Therapy (MDT) is a classification system utilizing direction-specific treatment for orthopedic conditions based on mechanical and symptomatic response to repeated end range movements. Read More

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http://dx.doi.org/10.1080/10669817.2019.1611044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006749PMC
February 2020
6 Reads

Value of Preoperative Imaging and Intraoperative Histopathology in Morton's Neuroma.

Foot Ankle Int 2019 Sep 29;40(9):1032-1036. Epub 2019 May 29.

1 Rothman Orthopaedic Institute, Philadelphia, PA, USA.

Background: Recent studies have demonstrated that clinical diagnosis of Morton's neuroma is highly correlated with operative and histopathologic diagnosis, whereas others have questioned the cost-effectiveness of intraoperative histopathology of excised specimens. The purpose of this study was to determine the utility of both preoperative imaging and intraoperative histology in the treatment of Morton's neuroma in making an accurate diagnosis, guiding treatment decisions, and altering clinical outcomes.

Methods: A retrospective review was performed on all patients who underwent operative resection suspected Morton's neuroma with 4 fellowship-trained foot and ankle surgeons between 2007 and 2017. Read More

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http://dx.doi.org/10.1177/1071100719851121DOI Listing
September 2019
15 Reads

Evaluation of results after distal metatarsal osteotomy by minimal invasive surgery for the treatment of metatarsalgia: patient and anatomical pieces study.

J Orthop Surg Res 2019 May 8;14(1):121. Epub 2019 May 8.

Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Julian Claveria, 33006, Oviedo, Spain.

Background: Metatarsalgia of the lesser toes is a common cause of consultation in the podiatric clinic. However, there continues to be a controversy with respect to which is the best surgical technique, and there is few information in the literature regarding objectively comparable results in percutaneous surgery.

Methods: The second metatarsal bones of 30 feet belonging to patients who had attended the podiatric clinic were studied before and after distal metatarsal pecutaneous osteotomy. Read More

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http://dx.doi.org/10.1186/s13018-019-1159-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505219PMC
May 2019
7 Reads

Mechanical Diagnosis and Therapy and Morton's Neuroma: A Case Report.

Authors:
Michael D Post

Physiother Can 2019 ;71(2):130-133

NYU Langone Health, Langone Orthopedic Center, New York.

Morton's neuroma (MN) is a neuralgia involving the common plantar digital nerves of the metatarsal region. Evidence-based treatment options for this condition are sparse, and physiotherapy's usefulness is limited. A woman aged 44 years was referred to physiotherapy for left forefoot pain lasting 3 months. Read More

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http://dx.doi.org/10.3138/ptc.2018-42DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484954PMC
January 2019
11 Reads