The patient complains of pain in the instep, of painful corns over the heads of the metatarsal bones, and of difficulty in getting properly fitting boots.
Flat-foot is frequently associated with stiff great toe; the patient having lost the power of dorsiflexing the toe, the first phalanx and first metatarsal are in a straight line, instead of forming an angle open towards the dorsum.
In aggravated cases the talus and the heads of the metatarsal bones may be excised.
Lange describes under this head a sinking or flattening of the anterior arch formed by the heads of the metatarsal bones, of which normally only the heads of the first and fifth rest on the ground.
The base of the second metatarsal and the first cuneiform are sometimes fractured.
There is a suppurating corn over the head of the first metatarsal bone.
This affection, which was first described by Morton of Philadelphia (1876), is a neuralgia on the area of the anterior metatarsal arch, specially located in the region of the heads of the third and fourth metatarsal bones.
The bases of the metatarsal bones are displaced laterally and towards the dorsum.
If one only is diseased, with the base of the metacarpal or metatarsal bone attached to it, the removal of these will be enough, and can be accomplished without difficulty.
In the amputation at the proximal joint, it is to be recollected that the extremity of the metatarsal bone lies more removed from the web of integument betwixt the toes than the metacarpal bone does from that of the fingers.
The preferable mode of making the flap, so as to expose the metatarsal bone for division or disarticulation, is well illustrated in the Practical Surgery, p.
Illustration] Unhealthy children are subject to disease of the phalanges, and of the metatarsal and metacarpal bones, excited by slight injury, or originating without apparent cause.
The operations on the other metatarsalbones are the same as those on the metacarpal.
In such circumstances, amputation is performed at the articulation of the metatarsal bones with the tarsus.
The plan of the incisions is the same as that for the operation at the bases of the metatarsal bones.
Illustration] Sometimes disease of the foot is not so extensive as to require or justify removal of the whole organ; the metatarsal bones are not involved throughout their whole extent.
In front of the metatarsal bones are placed the toes, which are connected with the metatarsal bones by joints.
It will be seen that it is an arch resting in front on the anterior heads of the five metatarsal bones, a, but chiefly on that of the great toe, and on the calcaneum or heel (b) behind.
This tendon, at the level of the metatarsal bones, divides into four slips, which pass towards the toes, and are inserted into the second and third phalanges of the latter.
The cuneiforms articulate with the internal half of the superior extremity of the principal metatarsal; the external half of this metatarsal articulates with the portion of bone which represents the cuboid.
The principal metatarsal is longer than the metacarpal of the same class; its shaft is more cylindrical; its inferior extremity is somewhat thicker.
The rudimentary metatarsalis a very small roundish bone, situated at the back of the superior extremity of the principal metatarsal.
The external rudimentary metatarsal is better developed than the internal; in the metacarpus the reverse is the case.
The phalanges of the two outer toes in each foot disappear, their metacarpal and metatarsal bones being left as the "splints.
The hind toes are three, like those of the fore leg; and the middle metatarsal bone is much less compressed from side to side than that of the horse.
The principal metacarpal and metatarsalbones are flatter than they are in any of the Equidae; and the metacarpal bones are longer than the metatarsals, as in the Palaeotheria.
The principal metacarpal and metatarsal bones are flatter than they are in any of the Equidoe; and the metacarpal bones are longer than the metatarsals, as in the Paloeotheria.
The metatarsals and digits, on the other hand, are proportionally longer and more slender, while the great toe is not only proportionally shorter and weaker, but its metatarsal bone is united by a more moveable joint with the tarsus.
Thus the great toe is the longest digit but one; and its metatarsal is far less moveably articulated with the tarsus, than the metacarpal of the thumb with the carpus.
The surgeon should measure with his eye the middle distance between the malleolus externus and the head of the metatarsal bone of the little toe, which is the situation of the articulation between the os cuboides and os calcis.
Butcher performs it by splitting up the sinuses leading to the carious joint, exposing it and cutting off with bone-pliers the anterior third of the metatarsal bone, and the proximal end of the first phalanx.
All that remains is to open the tarso-metatarsal joint.
Most surgeons are now agreed that in these toes it is best not to remove the head of the metatarsal bone with the toe.
There is no doubt that the anatomical conformation of the joints involved, especially the manner in which the head of the second metatarsal (Fig.
The author lately excised one-half of shaft of metatarsal and the corresponding half of proximal phalanx of great toe for exostosis, with antiseptic precautions.
To avoid the difficulties of disarticulation, Skey recommends cutting off the head of the second metatarsal with a pair of pliers.
His short account of it has at once surgical value and historical interest:-- "I made a mark across the upper part of the foot, to point out as exactly as I could the place where the metatarsal bones were joined to those of the tarsus.
If, however, the terminal branch of the dorsalis pedis artery be wounded, it may be necessary to disarticulate the first metatarsal to secure it rather than trust to compression to stop the bleeding.
As a rule, the native pays no attention to these sores, and from neglect the ulceration extends both on the surface and to the deeper tissues, exposing the tendons and the metatarsal bones.
A digit intimately united along its whole length with another digit, and having either an additional metacarpal or metatarsal bone of its own, or articulating with the head of one which is common to it and another digit.
Enchondroma is often found on the long bones, and very frequently upon the bones of the hands or on the metatarsal bones.
The conditions are not exactly symmetrical, since in some instances a metacarpal or metatarsal bone is wanting; or, to put it otherwise, two are welded together.
In the hind-feet the third and fourth toes are the longest, the second and fifth somewhat shorter and nearly equal, while the first is represented only by the rudimentary metatarsal bone.
In the case of a metacarpal or metatarsal bone, sub-periosteal resection is the procedure of choice, saving the articular ends if possible.
Tuberculous dactylitis# is the name applied to a diffuse form of the disease as it affects the phalanges, metacarpal or metatarsal bones.
Perforating ulcer is met with most frequently under the head of the metatarsal bone of the great toe.
Thus gangrene of the great toe often stops when it reaches the metatarso-phalangeal joint; or if it trespasses this limit it may be arrested either at the tarso-metatarsal or at the ankle joint.
The treatment of compound fractures of the metatarsal bones does not differ from that of other bones.
The entire head of the metatarsal is amputated, and the bursa is turned in over the cut end of bone, to diminish the amount of shortening and to prevent ankylosis of the joint.
Dislocations of the individual metatarsal bones are much rarer.
An effort is made to preserve the integrity of the capsule below (floor) as only the intra capsular end of the metatarsal is removed.
When the joint capsule is slit open along its dorsal and two lateral aspects, sufficient room is obtained for the insertion of the wire saw, and all of that portion of the metatarsal lying within the joint proper is removed.
The bursae most commonly involved are the prepatellar and that over the metatarsal joint of the great toe.
Relating to themetatarsal bones and the phalanges.
Amputation of the head of the metatarsal bone gives uniformly good results.
In the former case, the proximal end of the first phalanx and the dorsum of the foot are prominent, and the head of the metatarsal bone projects on the sole of the foot.
The scaphoid, cuneiform, and the base of the first metatarsalmove downward and inward with the head of the astragalus; the outer border of the foot is made more concave and the inner border becomes convex in extreme cases.
It varies from inability to flex the ankle beyond a right angle, to walking on the heads of the metatarsal bones.
This is the most important change in clubfoot, because the anterior end of the astragalus, the head of the bone, carries inward and downward with it the scaphoid, the three cuneiforms, and the inner three metatarsal bones.
Fracture of the metatarsal bones is liable to be followed by traumatic flat foot, on account of the sinking of the arch, or painful large calluses forming on the sole of the foot may interfere with walking.
It articulates with the second metatarsal and with the navicular.
The middle one is very small, it articulates with the first metatarsal and is probably tarsale 1.
The first metatarsal is nearly always free but occasionally as in Phaethon it is fused with the others.
It articulates with the third metatarsal and with the navicular.
In almost every case the phalanges and first metatarsal have epiphyses only on their proximal ends, while the remaining four metatarsals have epiphyses only on their distal ends.
The pre-axial one articulates with the metatarsalof the calcar, a structure to be described immediately, and has been regarded as a =centrale=.
The fifth metatarsal has a curious projecting process, and there is a large sesamoid above the hallux.
Each =digit= consists of a metatarsal and of a varying number of phalanges.
The =internal cuneiform= (tarsale 1) is a smooth flattened bone lying to the inner side of the foot; it articulates with the first metatarsal and with the navicular.
The fifth digit consists only of a small, somewhat squaremetatarsal (fig.
Four digits are present, each consisting of a metatarsal (already described) and a certain number of phalanges, the terminal one being in each case clawed.
It consists of a short metatarsal and one or two phalanges, and is terminated distally by a horny covering of epidermal origin.
In most birds the third metatarsal is curved so as not to lie in the same plane as the others, but in the Penguins they all three lie in the same plane.
The peronaeus tertius or anterior, is that part of the common extensor muscle which is inserted into the base of the fifthmetatarsal bone.
Reduction and final loss of outer pair of digits (second and fifth), with coalescence of the metacarpal and metatarsal bones of the two middle digits to form a cannon-bone.
Outer toes small and rudimentary, or in some cases entirely suppressed; their metacarpal or metatarsal bones never complete.
All specimens from Arteaga have two palmar tubercles; the inner and outer metatarsal tubercles are subequal in size.
In all specimens the first finger is noticeably longer than the second; the innermetatarsal tubercle is large, flat, and cream-colored, contrasting with the dark brown sole of the foot.
In the Pterodactylus longirostris the number of foot bones on the ordinary digits is two, three, four, five, as in lizards; but the short fifth metatarsal has only two toe bones.
There has been a suspicion that the metatarsal bones were separate in the young Archaeopteryx.
In the young of many birds the row of tarsal bones at the proximal end of the metatarsus comes away, and there is a partial division between the metatarsal bones, though they remain united in the middle.
There is no evidence of a pulley joint between the metatarsal and the adjacent phalange.
There are four somewhat elongated, slender metatarsal bones, which are separate from each other and never blended together, as in birds.
This evidence is found in the five metatarsal bones, of which four are in close contact, the middle two being slightly the longest, so as to present the general aspect of the corresponding bones in a Mammal rather than a Bird.
They bear much the same relation to the wing metacarpal that the large metatarsal of a Kangaroo has to the slender bones of the instep which are parallel to it.
The above list will hopefully give you a few useful examples demonstrating the appropriate usage of "metatarsal" in a variety of sentences. We hope that you will now be able to make sentences using this word.
