Numbness between the webs of the toes

Introduction Morton's headache is common in women, often unilateral, and the patient complains of pain in the toes and numbness in the corresponding toe gap.

Cause

(1) Causes of the disease

The disease is caused by a variety of factors causing the total nerve base of the toe.

(two) pathogenesis

1. Wearing high heels: For the most common cause of the disease, wearing high heels can increase the weight of the forefoot, excessive extension of the metatarsophalangeal joint, relaxation of the transverse ligament between the forefoot and the tibia, collapse of the transverse arch, and sinking of the bones of the 2nd, 3rd, and 4th, Just over the total nerve of the toe base located here, excessive compression, resulting in total toe-bottom neuroma. In addition, due to the collapse of the transverse arch, the sinking of the humeral head can compress the common toe artery adjacent to the common base of the humerus, causing obstruction of the artery, ischemia, hypoxia, and fibrosis of the toe.

2. Eversion: can cause the transverse arch to widen, collapse, and the humeral head sink, causing total nerve compression between the toes.

3. Trauma: the humeral neck fracture, the dislocation of the metatarsophalangeal joint, etc. can suppress the corresponding intermediate total nerve.

4. Congenital factors: such as flat foot, horizontal bow shallow or disappear, congenital first metatarsal shortening, can increase the pressure area of the first metatarsal head, compress the first and second base of the total nerve to produce symptoms.

an examination

Related inspection

CT examination of limbs and joints for limb and joint movement

1, more common in women, often unilateral onset, the patient complained of the pain of the toes and the corresponding gap between the toes and numbness, standing and walking increased, after taking off the shoes, gently moving the forefoot can be relieved, the pain is usually affected In the area of the humeral head, the nature of the pain can be dull, stinging or burning.

2. When inspecting, laterally squeezing the humeral heads, or squeezing the adjacent humeral head space from the dorsal and temporal sides of the suspected toe-bottom neuroma can produce pain and radiate to the adjacent two toes. The often affected part is the third toe gap, because the lowest position here, the total nerve of the toe is most likely to be stuck. The examiner uses the thumb and forefinger respectively to place the dorsal and temporal sides of the toe-ankle space of the suspected neuroma. The back and forth compression sometimes touches the neuroma to slide back and forth across the intersacral ligament, if there is an enlarged inter-sacral slip. A sac or an abnormally enlarged total toe-bottom neuroma, the affected two toe gaps can be wide. When you feel the feeling, you can find that the affected toe gap feels diminished or disappears.

3, according to medical history, clinical manifestations and local diagnostic closure, diagnosis can be established, X-ray examination can exclude bone changes.

Differential diagnosis

1. Skull skull cartilage disease: also known as Fieberg disease, occurs in adolescents, more common in women. Often occurs in the second metatarsal head, manifested as pain in the affected toe joint, increased when standing and walking, tenderness at the humeral head, and swelling of the soft tissue on the dorsal side. After the acute symptoms subsided, the humeral head increased and the metatarsophalangeal joint activity was limited. The X-ray film can be characterized as irregular and brightening of the distal end of the affected humeral epiphysis. The humeral head has crescent shape, depression and density increase, and has some small round translucent areas.

2. The joint of the toe joint: it can also be expressed as pain in the metatarsophalangeal joint, which is aggravated after activity and walking. It can be seen that the skin on the plantar side of the metatarsophalangeal joint is abnormally thickened and hardened, which may be tender, and the skin of the affected toe is normal.

3. The second metatarsal neck fatigue fracture: often caused by long-distance marching, or seen in long-distance runners, showing the pain of the second metatarsal head and neck, increased after walking, reduced after rest, but the skin between the toes is normal, early X The line was more normal, and there was periosteal reaction and osteophyte formation around the second metatarsal neck.

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