Maceira Ernesto, Monteagudo Manuel
Orthopaedic Foot and Ankle Unit, Complejo Hospitalario La Mancha Centro, Av de la Constitución 3, 13600 Alcazar de San Juan, Ciudad Real, Spain.
Orthopaedic Foot and Ankle Unit, Orthopaedic and Trauma Department, Hospital Universitario Quirónsalud Madrid, Faculty Medicine UEM, Calle Diego de Velázquez 1, Pozuelo de Alarcón, Madrid 28223, Spain.
Foot Ankle Clin. 2019 Dec;24(4):571-584. doi: 10.1016/j.fcl.2019.08.008. Epub 2019 Oct 8.
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.
步态的三摇椅机制为理解患者为何会出现跖骨机械性疼痛以及区分不同类型的跖痛症提供了一个框架。对患者进行临床检查并结合影像学检查结果，有助于确定跖痛症的类型以及所涉及的病理力学机制，并据此规划手术治疗方案。第二摇椅/非推进性跖痛症与跖骨在矢状面的异常倾斜有关，这种倾斜可以是解剖学上的，也可以是功能性的（马蹄足）。第三摇椅/推进性跖痛症与某一跖骨相对于相邻跖骨在横平面上的异常长度有关。
