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Titre : | Mechanical Basis of Metatarsalgia (2019) |
Auteurs : | Ernesto Maceira ; Manuel Monteagudo |
Type de document : | Article |
Dans : | Foot and Ankle Clinics (Vol. 24, n° 4, 2019) |
Article en page(s) : | p. 571-584 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Avant-pied humain ; Démarche ; Métatarsalgie ; Osteotomie ; Phénomènes biomécaniques |
Résumé : |
Identification and hierarchization of the mechanical impairments involved in each case is critical in order to eliminate pain and restore foot function as much as possible.
Functional or anatomic equinus is important during the second and the early third rocker but not at the late propulsive phase. Metatarsal length is important in third-rocker disorders but not in second-rocker overload. Patients may present with combined second-rocker and third-rocker disorder at a given ray or at different rays. There are several things that should not be done and that may be useful in the surgical planning of mechanical metatarsalgia: do not shorten a metatarsal with evidence of second-rocker overload (second-rocker keratosis, extensor over-recruitment), otherwise overloading will persist and the toe will develop additional dorsiflexion contracture; do not elevate a metatarsal with evidence of third-rocker overload (third-rocker keratosis, metacarpophalangeal joint instability), otherwise a central ray insufficiency syndrome may develop with second-rocker overload at the neighboring rays; do not lengthen the gastrocnemius in the absence of gastrocnemius-dependent equinus, as is the case in pure third-rocker disorder. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S1083751519300968 |