Metatarsalgia – A New Approach to a Difficult Problem
By: Michael Zapf, DPM, MPH, FACFAS
I am back from my annual January trek to Honduras with a team that performs
dramatic club foot surgery on the poor of that very poor country. We repaired
the misshapen feet of 30 children. You can see some of these beautiful children
on my web site. As you may remember this venture is sponsored by the Rotary
Clubs of Westlake Village Sunrise (mine) and of Agoura Hills / Oak Park. We pay
for this mission with a car raffle, this year our prize is a 3 year, 45,000
mile, maintenance included lease on a beautiful Mercedes E350. Again, my web
site has information on how you can help.
á Click here
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During some of the down time in Honduras, I had a long discussion on a very
common and very difficult problem of pain on the ball of the foot behind the
second toe. Pain here is one of the most common reasons people come to my
office. You can often see some swelling of the tissues on the ball of the foot
and frequently there is a second toe hammertoe. This is a progressive disorder
and can lead to a disfigured foot where the second toe crosses over the big toe,
especially if there is a bunion. This is one case where early treatment is
better than waiting for unfixable deformity. If you have a lump under and behind
the second toe, get thee to a foot doctor and orthotics are probably in your
future.
Here is a podiatric secret: we hate this deformity. When orthotics and softer
shoes do not provide enough relief we are left with a choice of a cortisone
injection or surgery. Injections can possibly make things worse in the long run
so we shy away from them if we can. But if a patient has a wedding or vacation
trip planned, we sometimes relent even though we know we shouldn’t.
Up to now, surgery has its own problems and at least half the time the foot
after surgery is different but not really better. Up to now. Putting together
ideas from my colleagues in Honduras, and another from San Diego I am, for the
first time, truly happy to have a new approach to this vexing problem. It
involves a transfer of a tendon in the toe to a new location and not the cutting
of the metatarsal bone. So, if you don’t win the car, and are forced to walk, I
can now make that a less painful experience. I look forward to explaining it in
greater detail.
Dr. Michael Zapf is a podiatrist in private practice in our community for 20
years. He and his associate, Dr. Darren Payne, have offices in Agoura Hills and
Thousand Oaks. For more information call their office at (818) 707-3668 or see
the web site www.conejofeet.com.
