A new radiological method for examining patients with forefoot deformities

Abstract

The aim of the study. To establish the possibility of using the X-ray method for determining the position of the metatarsal heads for preoperative planning in the treatment of patients with forefoot deformities.Material and methods. The proposed radiological method for determining the position of the metatarsal heads includes performing radiography on a special platform. On the X-ray image, the relative position of the metatarsal heads is determined. Using the proposed X-ray method, we examined 15 patients with transient metatarsalgia under the 3rd metatarsal head, which developed after surgical treatment of hallux valgus and hammertoe (2nd toe), and 28 patients with similar forefoot deformity without postoperative metatarsalgia.Results. As a result of the proposed X-ray method, we found that in in 86.67 % of patients with transient metatarsalgia, the 3rd metatarsal head was below the adjacent 2nd and 4th metatarsal heads. In 82.14 % of patients without postoperative complications, the 3rd metatarsal head was higher or at the same level as the adjacent 4th metatarsal head. The clinical application of the proposed method made it possible to determine the position of the 2nd, 3rd or 4th metatarsal heads and to establish normal variants and deviations from the norm.Conclusions. The proposed X-ray method makes it possible to effectively determine the relative position of the metatarsal heads and to choose the optimal surgical tactics for the treatment of patients with forefoot deformities. The proposed method for determining the position of the metatarsal heads is advisable to be included in the preoperative examination along with the standard X-ray of the foot bones, due to its reproducibility, as well as the value of the information obtained.