Prognosis of Painful Plantar Callosity after Hallux Valgus Correction without Lesser Metatarsal Osteotomy

Abstract

Painful plantar callosities under the lesser metatarsals in patients with hallux valgus deformity can be improved by hallux valgus correction alone without lesser metatarsal osteotomy.

The Biomechanical Relationship between Hallux Valgus Deformity and Metatarsal Pain

“…Our results showed that females had a higher incidence rate of HV, and the percentage of female patients was 87.0%, 96.0%, 95.9%, and 94% from group 1 to group 4, respectively. ere was no significant different in this rate between groups, which is consistent with the gender distribution of HV patients in the literature [6,20,21] (Table 1).…”

“…e main reason for this pain is that the medial ligamentous tension is weakened in early HV patients. With increasing severity in the degree of HV deformity, the phalanx slowly drifts into a valgus position and the metatarsal head escapes from the sesamoid platform [6]. e medial articular cartilage on the first metatarsal head thus loses the normal contact relation with the proximal phalanx and is no longer subjected to the normal pressure [6,7].…”

“…With increasing severity in the degree of HV deformity, the phalanx slowly drifts into a valgus position and the metatarsal head escapes from the sesamoid platform [6]. e medial articular cartilage on the first metatarsal head thus loses the normal contact relation with the proximal phalanx and is no longer subjected to the normal pressure [6,7]. Toe spacer pads [8], rehabilitation training [9], and orthotic footwear [10] all have been shown to improve the pressure to relieve pain from the first metatarsal.…”

“…is may be due to inaccurate loading location between the first ray and footwear [2]. Previous studies have also demonstrated the effect of the plantar callosities on metatarsal regions with aggravated HV [4,6,7].…”

“…Other research has found that increasing severity of HV degree results in increased load on the metatarsal heads [12]. is may be a result of the compression of the skin between footwear and the bunion protrusion [2], the abnormal contact relation of the articular cartilage [7], or extensor hallucis longus tendon dysfunction [6]. However, the relationship between metatarsal pain and the degree of HV severity has not been systematically examined.…”