Abstract des Autors

Pain in the forefoot is a frequently observed condition. Patients seek care for various reasons: pain, deformations, skin disorders, nail problems. The different diseases of the forefoot can be divided into several categories. Metatarsalgia due to mechanical disorders may be static or dynamic or related to osteodystrophy during growth, repeated microtrauma leading to stress fractures or sometimes to more serious conditions such as reflex neurodystrophy. Metatarsalgia may also result from a painful syndrome of the second metatarsophalanges secondary to hallus valgus or from pain in the intermetatarsal space as seen in Morton's disease. Inflammatory metatarsalgia results from rheumatoid, metabolic, infectious or tumoral processes. Disease of the toes involving the great toe, including hallus valgus and hallus rigidus, must be distinguished from those involving the other toes, including, claw toes, overlapping toes, quintus varus and inflammatory diseases. Exploration of the forefoot requires standard x-rays including weight-bearing AP and lateral views as well as various dynamic views depending on the situation. Medical treatment is sufficient in most cases. Surgery is reserved for failures of medical treatment or cases with invalidating pain when medical management has been unsuccessful. Verf.-Referat