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1.
Sports Health ; 12(4): 390-394, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32223694

RESUMO

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 metatarsophalangeal instability, athlete, forefoot pain, and metatarsalgia from database inception to 2019. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: Lesser MTP instability is a common condition, especially in the active and aging populations. It is frequently misdiagnosed, causing delays in treatment that allow for progressive pain and deformity, which prevents an active lifestyle. Fortunately, MTP instability can be diagnosed easily with the drawer test. Magnetic resonance imaging is helpful when still in doubt. Conservative treatment entails joint immobilization and gradual return to play with taping and offloading metatarsal pads. CONCLUSION: Lesser MTP instability is a common diagnosis. Its early detection and conservative treatment can help the patient regain their previous level of activity and avoid surgery.


Assuntos
Tratamento Conservador , Instabilidade Articular/diagnóstico , Instabilidade Articular/terapia , Metatarsalgia/etiologia , Fatores Etários , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/cirurgia , Traumatismos em Atletas/terapia , Humanos , Instabilidade Articular/complicações , Instabilidade Articular/cirurgia , Imagem por Ressonância Magnética , Metatarsalgia/diagnóstico , Metatarsalgia/cirurgia , Metatarsalgia/terapia , Exame Físico , Resultado do Tratamento
2.
BMC Musculoskelet Disord ; 20(1): 625, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881881

RESUMO

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. METHODS: A finite element model of the human foot simulating the push-off phase of the gait was established. Progressive shortening of the first metatarsal from 2 to 8 mm at an increment of 2 mm were sequentially applied to the model, and the corresponding changes in forefoot loading pattern during push-off phase, especially the loading ratio at the central rays, was calculated. The effect of depressing the first metatarsal head was also investigated. RESULTS: With increasing shortening level of the first metatarsal, the plantar pressure of the first ray decreased, while that of the lateral rays continued to rise. When the shortening reaches 6 mm, the load ratio of the central rays exceeds a critical threshold of 55%, which was considered risky; but it could still be manipulated to normal if the distal end of the first metatarsal displaced to the plantar side by 3 mm. CONCLUSIONS: During the first metatarsal osteotomy, a maximum of 6 mm shortening length is considered to be within the safe range. Whenever a higher level of shortening is necessary, pushing down the distal metatarsal segment could be a compensatory procedure to maintain normal plantar force distributions.


Assuntos
Antepé Humano/fisiologia , Ossos do Metatarso/cirurgia , Metatarsalgia/prevenção & controle , Osteotomia/métodos , Complicações Pós-Operatórias/prevenção & controle , Fenômenos Biomecânicos/fisiologia , Simulação por Computador , Análise de Elementos Finitos , Antepé Humano/anatomia & histologia , Antepé Humano/diagnóstico por imagem , Marcha/fisiologia , Hallux Valgus/cirurgia , Humanos , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/fisiologia , Metatarsalgia/etiologia , Osteotomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Tomografia Computadorizada por Raios X , Suporte de Carga
3.
Can Assoc Radiol J ; 70(4): 408-415, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31685098

RESUMO

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. We review normal anatomical features as well as MR imaging findings of common disorders.


Assuntos
Imagem por Ressonância Magnética/métodos , Metatarsalgia/diagnóstico por imagem , Dedos do Pé/anatomia & histologia , Dedos do Pé/diagnóstico por imagem , Humanos
4.
Foot Ankle Clin ; 24(4): 561-569, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653362

RESUMO

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. A thorough understanding of the multiple potential causal factors is essential to ensure selection of the optimal treatment.


Assuntos
Metatarsalgia/diagnóstico , Articulação Metatarsofalângica/anatomia & histologia , Algoritmos , Tomada de Decisão Clínica , Humanos , Metatarsalgia/etiologia , Metatarsalgia/fisiopatologia , Metatarsalgia/terapia , Articulação Metatarsofalângica/fisiopatologia
5.
Foot Ankle Clin ; 24(4): 571-584, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653363

RESUMO

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). Third-rocker/propulsive metatarsalgia is related to an abnormal length of a certain metatarsal with respect to the neighboring metatarsals in the transverse plane.


Assuntos
Metatarsalgia/fisiopatologia , Articulação Metatarsofalângica/fisiopatologia , Fenômenos Biomecânicos , Marcha , Humanos , Ossos do Metatarso/anatomia & histologia , Ossos do Metatarso/fisiopatologia , Metatarsalgia/etiologia , Metatarsalgia/cirurgia , Articulação Metatarsofalângica/cirurgia , Osteotomia
6.
Foot Ankle Clin ; 24(4): 585-598, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653364

RESUMO

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. Only limited scientific evidence is available in the literature. However, most of the techniques used in the treatment of metatarsalgia seem to be reasonable with acceptable results.


Assuntos
Metatarsalgia/terapia , Humanos , Metatarsalgia/classificação , Metatarsalgia/fisiopatologia , Metatarsalgia/cirurgia
7.
Foot Ankle Clin ; 24(4): 599-614, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653365

RESUMO

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. However, complications such as floating toes led to evolution of WO and the development of the triple-cut WO that allows for shortening coaxial to the shaft without plantar translation of metatarsal head. Other variations of WO may treat other forefoot disorders.


Assuntos
Metatarsalgia/cirurgia , Osteotomia/métodos , Humanos , Metatarsalgia/fisiopatologia
8.
Foot Ankle Clin ; 24(4): 615-625, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653366

RESUMO

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.


Assuntos
Ossos do Metatarso/cirurgia , Metatarsalgia/cirurgia , Osteotomia/métodos , Humanos , Ossos do Metatarso/diagnóstico por imagem , Metatarsalgia/diagnóstico por imagem , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Osteotomia/instrumentação
9.
Foot Ankle Clin ; 24(4): 641-648, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653368

RESUMO

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. It is imperative, in the treatment of first ray disorders (hallux valgus or hallux rigidus), to not overshorten the first ray when addressing the first ray pathologic condition. Treatment of metatarsalgia in the setting of failed hallux valgus correction can be treated with both conservative and surgical options.


Assuntos
Hallux Valgus/cirurgia , Ossos do Metatarso/cirurgia , Metatarsalgia/etiologia , Hallux Rigidus/complicações , Hallux Valgus/complicações , Humanos , Metatarsalgia/diagnóstico , Metatarsalgia/cirurgia , Osteotomia
10.
Foot Ankle Clin ; 24(4): 649-655, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653369

RESUMO

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.


Assuntos
Contratura/cirurgia , Metatarsalgia/cirurgia , Músculo Esquelético/cirurgia , Contratura/complicações , Contratura/diagnóstico , Contratura/fisiopatologia , Humanos , Metatarsalgia/diagnóstico , Metatarsalgia/etiologia , Metatarsalgia/fisiopatologia , Músculo Esquelético/fisiopatologia
11.
Foot Ankle Clin ; 24(4): 657-667, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653370

RESUMO

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). Unfortunately, metatarsalgia and lesser toe pathology is also common in this population. We present a review regarding the epidemiology, pathomechanics, and a comprehensive surgical treatment algorithm to optimize the management of patients with MA, HV, lesser toe deformity, and metatarsalgia.


Assuntos
Deformidades Congênitas do Pé/terapia , Metatarsalgia/terapia , Deformidades Congênitas do Pé/complicações , Deformidades Congênitas do Pé/epidemiologia , Deformidades Congênitas do Pé/fisiopatologia , Humanos , Metatarsalgia/etiologia , Metatarsalgia/fisiopatologia , Osteotomia
12.
Foot Ankle Clin ; 24(4): 677-687, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653372

RESUMO

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. Either acute lengthening (1-stage procedure) or gradual lengthening (2 stages) is selected based on the patient's deformities, concerns, and clinical needs.


Assuntos
Alongamento Ósseo/métodos , Deformidades do Pé/cirurgia , Ossos do Metatarso/cirurgia , Metatarsalgia/cirurgia , Transplante Ósseo , Deformidades do Pé/complicações , Deformidades do Pé/diagnóstico , Humanos , Ossos do Metatarso/anatomia & histologia , Metatarsalgia/etiologia , Osteotomia
13.
Foot Ankle Clin ; 24(4): 689-693, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653373

RESUMO

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. Patients with concurrent hallux valgus may benefit from a lapidus procedure or hallux metatarsophalangeal fusion in an effort to improve outcomes and decrease incidence of recurrent hallux valgus. In rare cases, diabetics with neuropathy may require resection arthroplasty in the setting of forefoot deformities recalcitrant to other modalities.


Assuntos
Artrite Reumatoide/cirurgia , Artroplastia/métodos , Deformidades Adquiridas do Pé/cirurgia , Metatarsalgia/cirurgia , Articulação Metatarsofalângica/cirurgia , Artrite Reumatoide/complicações , Deformidades Adquiridas do Pé/etiologia , Antepé Humano/cirurgia , Humanos
14.
Foot Ankle Clin ; 24(4): xiii-xiv, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653374
15.
J Orthop Surg Res ; 14(1): 121, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068197

RESUMO

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. The degree of shortening of the second metatarsal (RX) and the degree of functional recovery and perception of the well-being of the patient (AOFAS) were evaluated retrospectively. The same bones of 10 cadaveric feet were also studied. The surgical procedure was identical to that used on patients, and electronic callipers were employed to take measurements of the second metatarsal. The integrity of the plantar plate was checked visually. RESULTS: The mean shortening of the second metatarsal bone, as determined by the radiological study, was 2.76 mm. After an average follow-up period of 1.5 years, the final mean score on the AOFAS scale was 95.26 points. In none of the cases was the mobility of the metatarsophalangeal (MTP) joint affected. The mean shortening in the cadaveric feet was 2.10 mm, and in all cases, the plantar plate and flexor apparatus were perfectly preserved. CONCLUSIONS: Percutaneous osteotomy achieved, in our study, a lower degree of shortening than Weil's surgery, according to the data published in the literature. However, it shows good clinical results without causing problems of consolidation or rigidity in the MTP joint. Neither, with the caution that should be taken due to the use of experimental cadaver models, damage of the flexor apparatus of the foot is observed. These results suggest that this could be a safe and effective surgical procedure to be considered for metatarsalgias of the lesser rays.


Assuntos
Ossos do Metatarso/cirurgia , Metatarsalgia/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/tendências , Osteotomia/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Ossos do Metatarso/diagnóstico por imagem , Metatarsalgia/diagnóstico por imagem , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Osteotomia/métodos , Estudos Retrospectivos , Resultado do Tratamento
16.
J Biomech ; 87: 161-166, 2019 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-30824236

RESUMO

Data reduction techniques are commonly applied to dynamic plantar pressure measurements, often prior to the measurement's analysis. In performing these data reductions, information is discarded from the measurement before it can be evaluated, leading to unkonwn consequences. In this study, we aim to provide the first assessment of what impact data reduction techniques have on plantar pressure measurements. Specifically, we quantify the extent to which information of any kind is discarded when performing common data reductions. Plantar pressure measurements were collected from 33 healthy controls, 8 Hallux Valgus patients, and 10 Metatarsalgia patients. Eleven common data reductions were then applied to the measurements, and the resulting datasets were compared to the original measurement in three ways. First, information theory was used to estimate the information content present in the original and reduced datasets. Second, principal component analysis was used to estimate the number of intrinsic dimensions present. Finally, a permutational multivariate ANOVA was performed to evaluate the significance of group differences between the healthy controls, Hallux Valgus, and Metatarsalgia groups. The evaluated data reductions showed a minimum of 99.1% loss in information content and losses of dimensionality between 20.8% and 83.3%. Significant group differences were also lost after each of the 11 data reductions (α=0.05), but these results may differ for other patient groups (especially those with highly-deformed footprints) or other region of interest definitions. Nevertheless, the existence of these results suggest that the diagnostic content of dynamic plantar pressure measurements is yet to be fully exploited.


Assuntos
Pé/fisiopatologia , Hallux Valgus/fisiopatologia , Metatarsalgia/fisiopatologia , Pressão , Análise de Componente Principal/normas , Análise de Variância , Feminino , Humanos , Masculino , Procedimentos Cirúrgicos Reconstrutivos
17.
J Orthop Surg (Hong Kong) ; 27(1): 2309499019826325, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30798770

RESUMO

BACKGROUND: First metatarsophalangeal joint (MTPJ) arthrodesis is a common treatment modality for hallux rigidus with successful outcomes. However, the effect of arthrodesis on flexor digitorum longus (FDL) is poorly understood. The purpose of this study was to investigate this effect in a biomechanical model. METHODS: Ten cadaveric trans-knee amputated specimens were studied. Lesser toe range of motion (ROM) and FDL excursion on simulated FDL contraction were measured in the following three scenarios: (1) before 1st MTPJ arthrodesis, (2) after 1st MTPJ arthrodesis, and (3) after the knot of Henry release. RESULTS: 1st MTPJ arthrodesis reduced both mean lesser toe ROM and FDL excursion. However, there was improvement in these parameters after the knot of Henry release. CONCLUSIONS: FDL function was reduced following 1st MTPJ arthrodesis. This effect was contributed by soft tissue connections at the knot of Henry, where FDL crosses flexor hallucis longus (FHL). Therefore, with restriction of FHL movement after 1st MTPJ arthrodesis, FDL movement was also restricted. CLINICAL RELEVANCE: This result improved our understanding of 1st MTPJ arthrodesis biomechanics and suggested potential benefits of the knot of Henry release in 1st MTPJ arthrodesis to improve FDL function, thereby decreasing the rate of metatarsalgia and other associated problems.


Assuntos
Artrodese/efeitos adversos , Articulação Metatarsofalângica/fisiopatologia , Articulação Metatarsofalângica/cirurgia , Amplitude de Movimento Articular/fisiologia , Tendões/fisiopatologia , Idoso , Cadáver , Feminino , , Hallux Rigidus/cirurgia , Humanos , Masculino , Metatarsalgia , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Tendões/cirurgia
18.
Foot (Edinb) ; 38: 43-49, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30634162

RESUMO

BACKGROUND: Minimally invasive distal metaphyseal metatarsal osteotomy (DMMO) may be used to treat metatarsalgia and forefoot pathology. Few large series report its results or examine the degree of metatarsal shortening with this technique. The clinical and radiographic results of a cohort of patients treated with DMMOs at our unit are reported. METHODS: This was a single-centre retrospective study looking at the outcome of consecutive patients undergoing DMMOs. Demographics, radiological and clinical outcomes, complications and patient reported outcome measures (PROMs) were analysed. RESULTS: DMMOs on 106 toes in 43 feet were included. Mean age was 60.2±10.2 years and median follow-up was 38 months. Concurrent procedures were performed in 26 cases (60%). DMMO was performed on multiple toes in 42 cases (97%). Mean shortening achieved was 3.6±2.2mm, 4.1±1.6mm, and 3.6±1.6mm for the second, third and fourth metatarsals respectively. Mean time to fusion was 11.4±7.8 weeks and union occurred in 105 toes (99%). The single non-union was asymptomatic at 12 months. Two patients required a subsequent additional DMMO for transfer metatarsalgia. Minor complications were seen in 11 patients (26%). At final follow-up PROMs data was available for 42 cases: mean MOxFQ was 28.8±27.6, mean EQ-5D was 0.789±0.225, mean EQ-VAS was 68.5±20.3, mean VAS-Pain score was 3.1±2.8, and patients were satisfied overall in 40 cases (95%). CONCLUSIONS: The authors demonstrate excellent radiological and clinical outcomes in the short to medium term with DMMOs and present data on metatarsal shortening achieved with this technique.


Assuntos
Ossos do Metatarso/cirurgia , Metatarsalgia/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Osteotomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos
19.
J Foot Ankle Surg ; 58(2): 368-373, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30612867

RESUMO

To correct hallux valgus deformities in patients with advanced arthritis of the first metatarsophalangeal joint, we designed a new reverse chevron-type shortening osteotomy technique that could be used to correct valgus deformities at the proximal metatarsal level, as well as shorten and lower the metatarsal, in a 1-time procedure. Sixteen feet in 16 patients with a minimum of 18 months follow-up who underwent a shortening proximal chevron metatarsal osteotomy for a hallux valgus deformity with advanced arthritic change between January 2014 and March 2016 were reviewed in this study. Double chevron osteotomies with 20° of plantar-ward obliquity at the proximal metatarsal level were made at 5-mm intervals for simultaneous valgus correction and metatarsal shortening. An additional Weil osteotomy of the second metatarsal was performed in all feet. Patients' mean age was 57.88 ± 6.55 years. The deformity was satisfactorily corrected by the operation. The first metatarsal was shortened by approximately 8.75 mm, and the relative length of the second metatarsal did not differ significantly postoperatively (p = .179). The relative second metatarsal height, as seen on forefoot axial radiographs, was maintained constantly, with no significant difference (p = .215). No painful plantar callosity or transfer metatarsalgia under the second metatarsal head was observed postoperatively. A shortening proximal chevron metatarsal osteotomy for hallux valgus deformities with advanced arthritic change showed a good result with respect to deformity correction and pain relief. Appropriate lowering and an additional Weil osteotomy effectively prevented postoperative pain and painful callosity under the second metatarsal head.


Assuntos
Hallux Valgus/cirurgia , Ossos do Metatarso/cirurgia , Osteoartrite/cirurgia , Osteotomia/métodos , Adulto , Parafusos Ósseos , Fios Ortopédicos , Estudos de Coortes , Comorbidade , Feminino , Seguimentos , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/epidemiologia , Humanos , Masculino , Ossos do Metatarso/diagnóstico por imagem , Metatarsalgia/diagnóstico , Metatarsalgia/etiologia , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Osteoartrite/diagnóstico por imagem , Osteoartrite/epidemiologia , Osteotomia/instrumentação , Medição da Dor , Seleção de Pacientes , Radiografia/métodos , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
20.
Orthopedics ; 42(1): e138-e143, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30540873

RESUMO

Metatarsalgia can be viewed as more of a symptom rather than a distinct diagnosis. Timing of forefoot pain during the gait cycle and evaluation of whether the pain is from anatomic abnormalities, indirect overloading, or iatrogenic causes can suggest a specific metatarsalgia etiology. A thorough physical examination of the lower extremity, especially evaluation of the plantar foot, and weight-bearing radiographs are critical for diagnosis and treatment. Nonoperative treatment consists of physical therapy, orthotics, shoe wear modification, and injections. If conservative treatment fails, surgical options may be considered. [Orthopedics. 2019; 42(1):e138-e143.].


Assuntos
Metatarsalgia/diagnóstico , Metatarsalgia/etiologia , Artrite Reumatoide/complicações , Pé Equino/complicações , Pé/diagnóstico por imagem , Fraturas Ósseas/complicações , Gota/complicações , Humanos , Doença Iatrogênica , Ossos do Metatarso/diagnóstico por imagem , Metatarso/anormalidades , Neuroma Intermetatársico/complicações , Osteocondrite/complicações , Osteocondrite/congênito , Exame Físico , Psoríase/complicações , Sinovite/complicações , Sinovite/etiologia
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