Abstract
Category:
Lesser Toes
Introduction/Purpose:
Minimally invasive surgery through percutaneous technique has developed significantly in recent years, increasing its indication for correction of foot deformities, especially in the forefoot region. The treatment of severe metatarsalgia remains a challenge for surgeons, especially in techniques requiring larger incisions.
Methods:
We prospectively evaluated 16 patients diagnosed with metatarsalgia with plantar keratosis associated with metatarsophalangeal dislocation of the lesser toes submitted to surgical correction by the distal metatarsal metaphyseal osteotomy (DMMO) technique. Clinical (AOFAS, FFI and VAS) and radiographic scores were used, as well as personal satisfaction criteria.
Statistical analysis was performed using the Mann-Whitney U test and Fisher’s Exact Test with the R software ‘Stats’ package.
Results:
One participant was lost to follow-up, totaling a sample of 15 patients and 16 feet (a bilateral case). The mean follow-up was 14 months (6 - 23) and the mean age of the sample was 73.53 (62 - 85). There was a significant reduction in postoperative status with a reduction in VAS of 5.47 (p <0.001) and a difference in metatarsalgia after the procedure, ranging from 100% of cases to 13% (p <0.001). All patients stated that they would do the procedure again if necessary and most (73%) defined it as satisfied with the procedure (Coughlin Score).
Conclusion:
The DMMO technique for the treatment of metatarsalgia in patients with metatarsophalangeal dislocation of the lesser toes has shown good results, reducing pain and high satisfaction index, demonstrated by preliminary results.