Results of surgical treatment for Morton's foot

Abstract

Introduction: Morton’s foot is a syndromatic diagnosis that includes several deformities like gastrocnemius muscle imbalance, painful instability of the first metatarsal-cuneiform joint, metatarsus primus varus, hallux valgus (HV), and distal metatarsalgia of the 2nd and 3rd rays. Furthermore, Morton’s foot should be considered as a painful complex dysfunctional foot, considering separately a treatment for every deformity, in order to ensure a normal painless gait. The aim of this study is to prospectively evaluate the functional results of all surgical procedures performed on Morton’s foot at Centro Médico Imbanaco, Cali, Colombia.

Methods: We performed a prospective cohort study to determine the functional and clinical results in all patients admitted in our institution with a diagnosis of Morton’s foot who underwent to a one step hallux valgus and additional surgical procedures for forefoot corrections from August 1st 2006 through November 30th 2008. We did evaluate clinical results, satisfaction level of the patient and end stage functional class.

Results: 38 feet in 34 patients were included; mean metatarsal-phalangeal angle was diminished from 35 degrees to 5 degrees while intermetatarsal angle was diminished from 15 degrees to 5 degrees. Visual analog scale (VAS) was diminished from 8.5 to 1.5 six months after the surgical procedures. AOFAS scale improves from an initial mean value of 59 points to a mean score of 93 points. On SF-36 scale 45% of the patients considered a substantial improve in life quality being able to perform sports, whether 38% of the patients considered themselves having better health when comparing it with their previous status before surgery was performed. It is important to describe that 25% of the patients remained with local edema on the forefoot six months after surgery.

Discussion: When a rationale and progressive surgical approach is performed on Morton’s foot, a predictable good result rate can be expected, as it was seen in this study.