Eulry F
Service de rhumatologie Hôpital d'instruction des armées Bégin, Saint-Mandé.
Rev Prat. 1997 Jan 1;47(1):37-42.
Static metatarsalgia involves pain of non-inflammatory origin in the region of the metatarsal heads. It is caused by a functional disorder or anatomic derangement of the architecture over the ball of the foot, whether congenital or acquired, evident or not. Clinical examination, including of the shoe and of the plantar orthosis, distinguishes five types of anomalies: 1. horizontal malalignment of the metatarsal heads with insufficiency at the first metatarsal-phalangeal joint, dominated by hallux valgus, and involvement of the second metatarsal bone, sometimes favouring Freiberg's disease; 2. vertical malalignment, with a hollow anterior foot, sometimes complicated by Morton's neuroma; 3. a combination of these two anomalies, easily diagnosed but less easily treated; 4. possible enlargement of the first metatarsal-phalangeal joint (hallux rigidus, sesamoid pathology); 5. no patent architectural anomalies, but stress fractures or bone insufficiency fractures of the metatarsals. Only clinical examination can orient complementary strategy and examinations.
静态跖痛症是指跖骨头区域出现的非炎性疼痛。它由足跖球部结构的功能紊乱或解剖结构紊乱引起，无论是先天性还是后天性的，明显与否。临床检查，包括对鞋子和足底矫形器的检查，可区分出五种异常类型：1. 跖骨头水平排列不齐，第一跖趾关节功能不全，以拇外翻为主，累及第二跖骨，有时易患弗赖伯格病；2. 垂直排列不齐，前足呈凹陷状，有时并发莫顿神经瘤；3. 这两种异常的组合，易于诊断但治疗较难；4. 第一跖趾关节可能肿大（拇僵硬症、籽骨病变）；5. 无明显的结构异常，但有跖骨应力性骨折或骨不全性骨折。只有临床检查才能指导进一步的检查策略和检查项目。
