Background: Clinical and radiological results of percutaneous distal metatarsal minimally invasive osteotomy (DMMO) of the lesser rays for surgical treatment of primary metatarsalgia due to plantar overpressure with metatarsophalangeal instability are described. The aim of this prospective study was to assess the efficacy, feasibility and safety of this minimally invasive surgical (MIS) technique, verifying the possibility to lower the complication rate related to surgical exposures, to reduce operating times with comparable functional and cosmetic results to those reported with traditional open procedures.Methods: Hundred and six consecutive percutaneous distal osteotomies without fixation (DMMO) of the second, third or fourth metatarsal bones were performed in 57 patients (70 ft) with a mean age at the surgery of 60.2 years (30-81) for treatment of metatarsalgia with metatarsophalangeal instability. Patients were clinically assessed with the AOFAS and Coughlin's Scores, the latter classifying the results in relation to the patient's subjective satisfaction.Results: The mean follow-up was of 45.0 +/- 13.3 months (24-68). All patients reported the disappearance or reduction of the pain that they had experienced prior to the operation around the metatarsal heads. The mean overall AOFAS score improved from 42.7 +/- 13.4 points (9-77) to 92.8 +/- 8.6 points (44-100) at the time of final follow-up. Patient subjective satisfaction according to Coughlin's classification was excellent in 62 ft (88.6%), good in 7 ft (10.0%), fair in 0 ft and poor in one foot (1.4%).Conclusions: We consider the percutaneous distal lesser metatarsal osteotomy without fixation (DMMO) a reliable surgical option in metatarsalgia due to metatarsophalangeal instability in early stages as in grade I and II according to Coughlin classification. (C) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Percutaneous distal osteotomy of lesser metatarsals (DMMO) for treatment of metatarsalgia with metatarsophalangeal instability

Magnan, B.;Bonetti, I.;Negri, S.;Maluta, T.;Dall'Oca, C;Samaila, E.
2018-01-01

Abstract

Background: Clinical and radiological results of percutaneous distal metatarsal minimally invasive osteotomy (DMMO) of the lesser rays for surgical treatment of primary metatarsalgia due to plantar overpressure with metatarsophalangeal instability are described. The aim of this prospective study was to assess the efficacy, feasibility and safety of this minimally invasive surgical (MIS) technique, verifying the possibility to lower the complication rate related to surgical exposures, to reduce operating times with comparable functional and cosmetic results to those reported with traditional open procedures.Methods: Hundred and six consecutive percutaneous distal osteotomies without fixation (DMMO) of the second, third or fourth metatarsal bones were performed in 57 patients (70 ft) with a mean age at the surgery of 60.2 years (30-81) for treatment of metatarsalgia with metatarsophalangeal instability. Patients were clinically assessed with the AOFAS and Coughlin's Scores, the latter classifying the results in relation to the patient's subjective satisfaction.Results: The mean follow-up was of 45.0 +/- 13.3 months (24-68). All patients reported the disappearance or reduction of the pain that they had experienced prior to the operation around the metatarsal heads. The mean overall AOFAS score improved from 42.7 +/- 13.4 points (9-77) to 92.8 +/- 8.6 points (44-100) at the time of final follow-up. Patient subjective satisfaction according to Coughlin's classification was excellent in 62 ft (88.6%), good in 7 ft (10.0%), fair in 0 ft and poor in one foot (1.4%).Conclusions: We consider the percutaneous distal lesser metatarsal osteotomy without fixation (DMMO) a reliable surgical option in metatarsalgia due to metatarsophalangeal instability in early stages as in grade I and II according to Coughlin classification. (C) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
Metatarsalgia
Metatarsophalangeal instability
Minimally invasive surgery
Percutaneous distal osteotomy
File in questo prodotto:
File Dimensione Formato  
PERCUTANEE MT LATERALI FAS 2017.pdf

solo utenti autorizzati

Descrizione: Full text pdf
Tipologia: Documento in Post-print
Licenza: Accesso ristretto
Dimensione 2.35 MB
Formato Adobe PDF
2.35 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/973082
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 15
  • ???jsp.display-item.citation.isi??? 10
social impact