Metatarsal Bones

A 53-year-old woman with rheumatoid arthritis on oral prednisone presented to a podiatric surgeon after a lifelong history of hallux valgus and lesser toe deformities. After failure of conservative management options, she opted for surgical management with first metatarsophalangeal joint arthroplasty with a double-stem silastic implant. Hammertoe deformities of her second through fifth digits were treated with lesser metatarsal head resections with transarticular pin fixation. The patient’s postoperative period was unremarkable, but after about 2 months, she noticed recurrence of the deformity of the lesser toes. She also developed a painful plantar prominence at the hallux metatarsophalangeal with return of the valgus deformity. After 4 years of persistent pain, she was referred to orthopedic surgery for further evaluation.

Compared with dorsiflexion closing wedge metatarsal osteotomy, investigators found osteochondral autologous transplantation was safe and effective for the treatment of Freiberg infraction in an athletic population.

Arthrosurface Inc. received FDA 501(k) clearance for its BOSS toe fixation system, which is intended to improve stabilization in a first metatarsal with a distal bone void.

CHICAGO — At the American Orthopaedic Foot and Ankle Society Annual Meeting, Steven M. Raikin, MD, discussed a study that looked at degenerative changes at the metatarsal head sesamoid articulation seen during surgery for hallux valgus correction. He said there was a high incidence of arthritis (87%) at the metatarsal head sesamoid articulation.