Abstract / Summary
Background Metatarsalgia is a generic term used to describe localised forefoot pain around the metatarsals. Primary metatarsalgia is thought to be caused by excessive loading over one or multiple metatarsal heads resulting in localised inflammation and painful callosities. An ideal foot morphotype was described by Maestro et al., which is currently used to plan for corrective osteotomies. The aim of this study is to investigate whether there is a true difference in metatarsal lengths between symptomatic and asymptomatic individuals. Methods A retrospective single centre study was carried out between 2019 and 2020. Weightbearing dorsoplantar foot radiographs were screened. Patients were grouped into two groups, Group A: Asymptomatic foot and Group B: Primary metatarsalgia. Exclusion criteria were set to exclude patients with previous foot surgery and secondary causes of metatarsalgia (e.g. Morton’s Neuroma). Metatarsal length differences were measured according to Maestro’s criteria using Carestream. Results There were 172 patients in Group A and 34 patients in Group B. There was no statistically significant difference in metatarsal length differences between the two groups (p = 0.473). Twelve patients in group B (35%), underwent surgical intervention with a corrective osteotomy. In this subgroup a significant difference in the pre-operative metatarsal length difference was found between the 1st and 2nd metatarsals (M1-M2) (p = 0.034) compared to Group A. This was due to a longer 2nd metatarsal (p = 0.035). Conclusion Our results highlight that patients with primary metatarsalgia have a similar metatarsal arcade when compared to the “normal” asymptomatic foot. Further clinical studies are required to help identify patients requiring surgical treatment and outcomes in patients undergoing corrective osteotomy for primary metatarsalgia.