Gay L. Diagnosis and surgical treatment of metatarsalgia

The thesis deals with the problem of diagnosis and surgical treatment of patients with metatarsalgia. Based on the important clinical, radiographical, ultrasonography, plantography, biomechanical and statistical methods of investigation, absence of connection between localization of metatarsalgia and angular parameters of the forefoot in patients with hallux valgus, Connection established between the relative length of the 1 st metatarsal and localization metatarsalgia, as well as for the first time The influence of elongation of the 1 st metatarsal bone as a result of surgical correction for hallux valgus in a reduction of metatarsalgia. Moreover, we demonstrated the effect of correction of metatarsophalangeal angle following the reduction of metatarsalgia under the head of the 1 st metatarsal bone, the impact of the correction of angle indicators (MPhA, 1-2 IMA, 1-5 IMA) on the reduction metatarsalgia with its localization under the metatarsal heads, 2.4 bones. Based on the study of the present literatures and personal experiences (87 patients with metatarsalgia), theoretically justified the method of surgical treatment of hallux valgus combined with metatarsalgia the application of which can improve efficiency of a treatment, namely to increase by 17% the number of good outcomes, reduced on average by 5 -7 days, the duration of the hospital stay, decrease in the period of medical and social rehabilitation for 3-4 weeks compared with traditional methods of treatment of metatarsalgia. And as a result of research of fundamental importance is that for the first time sonography shows degenerative changes of the plantar plate capsule metatarsophalangeal joint as an anatomic substrate metatarsalgia, forcing to reconsider the definition of metatarsalgia as entezopatii forefoot (ICD-10).