METATARSUS ATAVICUS

The Identification of a Distinctive Type of Foot Disorder

¹ The Department of Surgery, Yale University, School of Medicine, New Haven, Conn., Research Associate, American Museum of Natural History, N. Y.

1. Identification of this type of disorder facilitates the recognition and treatment of what appears to be a very large group of painful foot cases. Although in its range of subjective symptoms the present condition simulates other metatarsal disorders, the means of diagnosis and the elements of treatment are distinctive and specific.

2. The intensity of symptoms is not determined by the degree of disproportion in the length of the first and second metatarsal bones alone, but to an equal degree by the violence and distribution of the strains and stresses to which the foot is subjected. Hence, an adult foot with only a mild shortening of the first metatarsal bone, but which is subjected to frequent severe strains or prolonged periods of standing, is more likely to present disabling symptoms than one with, greater inequality in the length of the bones, but which is not subject to heavy or vicious usage.

3. The early part of the treatment consists of eliminating the effects of chronic traumatic irritation. When this has been accomplished, conditions have been restored which characterized the efficient and painless state of this type of foot prior to the onset of symptoms. Subsequent care does not seem to require more than the use of conservative measures such as have been described, in order to maintain that symptomless state.

4. The question as to a proper designation of the condition has been given very serious consideration,—whether "Atavicus" as an etiologically descriptive term, or whether the name "Metatarsus primus brevior" as a morphological description, would be the more suitable. The former term was selected for two reasons: (1) because there is little doubt but that the short first metatarsal bone is a congenitally transmissible characteristic of a mild, but distinctly atavistic nature; and (2) owing to the writer's conviction that much of value to Medicine and Surgery is to be gained by increased knowledge of man's evolutionary development. It is hoped that the name "Metatarsus Atavicus" may carry with it a real appreciation of the practical value which anthropological researches hold in their fundamental relationship with the daily problems of the medical profession.

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