Metatarsalgia due to insufficient support by the first ray

Area of Science:

• Podiatry
• Orthopedic Surgery
• Biomechanics

Background:

• Metatarsalgia is often caused by inadequate first ray support.
• Deficient anteromedial support leads to abnormal forefoot loading.

Purpose of the Study:

• To classify first ray morphology in relation to deficient anteromedial support.
• To propose surgical and conservative treatment strategies for metatarsalgia.
• To evaluate the outcomes of interventions aimed at restoring normal forefoot loading.

Main Methods:

• Classification of 65 feet based on first ray morphology and anteromedial support.
• Surgical interventions including soft tissue, bone, or combined procedures.
• Tarsal derotation osteotomy for forefoot supination.
• Conservative and surgical management for abnormal first ray morphology.

Main Results:

• A classification system for deficient anteromedial support related to first ray morphology was developed.
• Surgical options were proposed for elevated first ray, addressing soft tissues, bone, or both.
• Tarsal derotation osteotomy effectively corrected forefoot supination, with combined procedures for associated first ray elevation.
• Both conservative and surgical treatments were employed for abnormal first ray morphology, with outcomes described.

Conclusions:

• Understanding first ray morphology is crucial for treating metatarsalgia due to inadequate anteromedial support.
• Tailored surgical and conservative approaches can effectively restore normal forefoot biomechanics and alleviate pain.