Department of Orthopaedics, University of Zurich, Balgrist Hospital, Zurich, Switzerland.
J Am Acad Orthop Surg. 2010 Aug;18(8):474-85. doi: 10.5435/00124635-201008000-00004.
Metatarsalgia (ie, metatarsal pain) is one of the most common reports in patients with foot problems. This pain is confined to the area across the plantar forefoot, including the second through fourth metatarsal heads. However, it is frequently accompanied by deformity of the first and fifth rays as well as of the toes. There is great variability in possible causative factors, but all of them seem to be related to gait mechanics, foot anatomy, and foot and ankle deformity. An individualized treatment protocol is required. Nonsurgical management is usually sufficient to achieve satisfactory results. Surgical correction must be precise, and all pain-producing deformities must be corrected. Most patients present with abnormalities of the distal metatarsals. Metatarsal osteotomy, long a staple of treatment, always fails in the long term. Improved equipment and internal fixation methods may lead to better long-term outcomes.
跖痛症（即跖骨疼痛）是足部问题患者最常见的报告之一。这种疼痛局限于足底前足区域，包括第二至第四跖骨头。然而，它通常伴随着第一和第五跖骨以及脚趾的畸形。可能的致病因素差异很大，但所有这些因素似乎都与步态力学、足部解剖结构以及足部和踝关节畸形有关。需要制定个体化的治疗方案。非手术治疗通常足以取得满意的效果。手术矫正必须精确，所有引起疼痛的畸形都必须矫正。大多数患者表现为远端跖骨异常。跖骨截骨术长期以来一直是治疗的主要方法，但总是失败。改进的设备和内固定方法可能会带来更好的长期效果。
