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Treatment of Metatarsalgia

  • Jean-Luc Besse
Chapter
Part of the European Instructional Lectures book series (EICL, volume 12)

Abstract

This instructional lecture concerns metatarsalgia treatment. The author gives some anatomical and biomechanical reminders explaining specifically propulsive in contrast to static metatarsalgia. Aetiologies are classified as primary, secondary and iatrogenic. Clinical assessment, recent radiological data such as Maestro criteria and forefoot morphotypes, and MRI and ultrasound contributions are described. Therapeutic methods are developed: conservative treatment (stretching exercises, shoe modifications, functional orthotic devices, debridement of lesions), and surgical procedures (contra-indicated techniques; soft tissue procedures with gastrocnemius muscle release, tendon transfers, plantar plate suture; metatarsal osteotomy, focusing on Weil osteotomy and percutaneous distal osteotomy; and lesser metatarso-phalangeal joint implants). A treatment algorithm is presented, according to the presence or absence of 1st ray abnormalities and separate inflammatory disease. The conclusion outlines “take-home messages”.

Keywords

Hallux Valgus Plantar Pressure Proximal Phalanx Metatarsal Head Metatarsophalangeal Joint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure of Interest

No conflict of interest.

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Copyright information

© EFORT 2012

Authors and Affiliations

  1. 1.Université Lyon 1, IFSTTAR,LBMC UMR-T 9406 - Laboratoire de Biomécanique et Mécanique des ChocsBron CedexFrance
  2. 2.Hospices Civils de Lyon, Centre Hospitalier Lyon-SudService de chirurgie Orthopédique et TraumatologiquePierre-Bénite CedexFrance

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