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Sep 13

Written by: Larry Huppin, DPM
9/13/2010 2:01 PM

I had a patient present several weeks ago with lesser metatarsal pain. This was secondary to an iatrogenic short first.  In fact, the first met head did not touch the ground, leading to rather severe pressure (and pain) under the other metatarsal heads.  

Our treatment goal was to help the first met head bear weight and to transfer pressure off of the lesser met heads.   

You can see on the picture at right how the first met head is not bearing weight.   

Our orthotic prescription was for a semi-rigid poly orthosis with both a rearfoot post and a forefoot post.  The forefoot post was prescribed with 3 degrees of varus correction to support the first ray and essentially bring the ground up to meet the foot.   In addtion we included a Morton's extension to support under the first met head.  We left the cover unglued on the front half of the orthosis so that we could modify the Morton's extension if necesasry.  

You can see here how the orthosis now is supporting the first ray and the first met head. If he continues to have pain, we may increase the thickness of the Morton's extension.    

If you have questions on any orthotic related issue, contact a ProLab medical consultant.  

 

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