대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제21권3호
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  • Pages.83-87
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  • 2017
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  • 1738-3757(pISSN)
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  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
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중족골통에서의 소족지 중족 절골술

Lesser Metatarsal Osteotomies for Metatarsalgia

  • 이승열 (가톨릭대학교 의과대학 부천성모병원 정형외과학교실) ;
  • 정진화 (가톨릭대학교 의과대학 부천성모병원 정형외과학교실)
  • Lee, Seung-Yeol (Department of Orthopedic Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Chung, Jin-Wha (Department of Orthopedic Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea)
  • 투고 : 2017.08.08
  • 심사 : 2017.09.11
  • 발행 : 2017.09.15
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초록

Metatarsalgia means the pain under the lesser metatarsal heads. The many causes of metatarsalgia can be categorized into three groups: local disease in the region, altered forefoot biomechanics, and systemic disease affecting the region. Surgical options need to be considered if nonsurgical treatment fails. The metatarsal osteotomies are designed primarily to reduce the weightbearing forces on the metatarsal head by elevating or shortening the metatarsal. Many lesser metatarsal osteotomies have been described, and their success depends on many factors. Regardless of the method employed, it is important to maintain or restore the metatarsal cascade to maintain an even pressure under the lesser metatarsal heads and prevent transfer lesions. The surgeon must understand the effects of the metatarsal osteotomy on the forefoot patho-biomechanics and decide, using a combination of clinical examinations and imaging, whether the desired effect of the osteotomy is to shorten or elevate the metatarsal head or both.

키워드

참고문헌

  1. Feibel JB, Tisdel CL, Donley BG. Lesser metatarsal osteotomies. A biomechanical approach to metatarsalgia. Foot Ankle Clin. 2001;6:473-89. https://doi.org/10.1016/S1083-7515(03)00108-6
  2. Espinosa N, Maceira E, Myerson MS. Current concept review: metatarsalgia. Foot Ankle Int. 2008;29:871-9. https://doi.org/10.3113/FAI.2008.0000X
  3. Aronow MS, Diaz-Doran V, Sullivan RJ, Adams DJ. The effect of triceps surae contracture force on plantar foot pressure distribution. Foot Ankle Int. 2006;27:43-52. https://doi.org/10.1177/107110070602700108
  4. Maskill JD, Bohay DR, Anderson JG. Gastrocnemius recession to treat isolated foot pain. Foot Ankle Int. 2010;31:19-23. https://doi.org/10.3113/FAI.2010.0019
  5. O'Kane C, Kilmartin TE. The surgical management of central metatarsalgia. Foot Ankle Int. 2002;23:415-9. https://doi.org/10.1177/107110070202300508
  6. Pearce CJ, Calder JD. Metatarsalgia: proximal metatarsal osteotomies. Foot Ankle Clin. 2011;16:597-608. https://doi.org/10.1016/j.fcl.2011.08.007
  7. Schuh R, Trnka HJ. Metatarsalgia: distal metatarsal osteotomies. Foot Ankle Clin. 2011;16:583-95. https://doi.org/10.1016/j.fcl.2011.08.009
  8. Leventen EO, Pearson SW. Distal metatarsal osteotomy for intractable plantar keratoses. Foot Ankle. 1990;10:247-51. https://doi.org/10.1177/107110079001000501
  9. Maestro M, Besse JL, Ragusa M, Berthonnaud E. Forefoot morphotype study and planning method for forefoot osteotomy. Foot Ankle Clin. 2003;8:695-710. https://doi.org/10.1016/S1083-7515(03)00148-7
  10. Toth K, Huszanyik I, Kellermann P, Boda K, Rode L. The effect of first ray shortening in the development of metatarsalgia in the second through fourth rays after metatarsal osteotomy. Foot Ankle Int. 2007;28:61-3. https://doi.org/10.3113/FAI.2007.0011
  11. Beech I, Rees S, Tagoe M. A retrospective review of the Weil metatarsal osteotomy for lesser metatarsal deformities: an intermediate follow-up analysis. J Foot Ankle Surg. 2005;44:358-64. https://doi.org/10.1053/j.jfas.2005.07.002
  12. Grimes J, Coughlin M. Geometric analysis of the Weil osteotomy. Foot Ankle Int. 2006;27:985-92. https://doi.org/10.1177/107110070602701121
  13. Migues A, Slullitel G, Bilbao F, Carrasco M, Solari G. Floating-toe deformity as a complication of the Weil osteotomy. Foot Ankle Int. 2004;25:609-13. https://doi.org/10.1177/107110070402500902
  14. Trnka HJ, Nyska M, Parks BG, Myerson MS. Dorsiflexion contracture after the Weil osteotomy: results of cadaver study and three-dimensional analysis. Foot Ankle Int. 2001;22:47-50. https://doi.org/10.1177/107110070102200107
  15. Snyder J, Owen J, Wayne J, Adelaar R. Plantar pressure and load in cadaver feet after a Weil or chevron osteotomy. Foot Ankle Int. 2005;26:158-65. https://doi.org/10.1177/107110070502600208
  16. Khurana A, Kadamabande S, James S, Tanaka H, Hariharan K. Weil osteotomy: assessment of medium term results and predictive factors in recurrent metatarsalgia. Foot Ankle Surg. 2011;17:150-7. https://doi.org/10.1016/j.fas.2010.04.003
  17. Vernois J, Redfern D, Ferraz L, Laborde J. Minimally invasive surgery osteotomy of the hindfoot. Clin Podiatr Med Surg. 2015;32:419-34. https://doi.org/10.1016/j.cpm.2015.03.008
  18. Haque S, Kakwani R, Chadwick C, Davies MB, Blundell CM. Outcome of minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) for lesser toe metatarsalgia. Foot Ankle Int. 2016;37:58-63. https://doi.org/10.1177/1071100715598601
  19. Kitaoka HB, Patzer GL. Chevron osteotomy of lesser metatarsals for intractable plantar callosities. J Bone Joint Surg Br. 1998;80:516-8. https://doi.org/10.1302/0301-620X.80B3.8383
  20. Trnka HJ, Kabon B, Zettl R, Kaider A, Salzer M, Ritschl P. Helal metatarsal osteotomy for the treatment of metatarsalgia: a critical analysis of results. Orthopedics. 1996;19:457-61.
  21. Wolf MD. Metatarsal osteotomy for the relief of painful metatarsal callosities. J Bone Joint Surg Am. 1973;55:1760-2. https://doi.org/10.2106/00004623-197355080-00024
  22. Trnka HJ, Muhlbauer M, Zettl R, Myerson MS, Ritschl P. Comparison of the results of the Weil and Helal osteotomies for the treatment of metatarsalgia secondary to dislocation of the lesser metatarsophalangeal joints. Foot Ankle Int. 1999;20:72-9. https://doi.org/10.1177/107110079902000202
  23. Fleischli JE, Anderson RB, Davis WH. Dorsiflexion metatarsal osteotomy for treatment of recalcitrant diabetic neuropathic ulcers. Foot Ankle Int. 1999;20:80-5. https://doi.org/10.1177/107110079902000203