González UJ, Parals GF, Conesa MX, Ribau DMÁ, Vía-Dufresne PO, Siles FE, Novell AJ

Language: Spanish
References: 15
Page: 112-121
PDF size: 305.41 Kb.

ABSTRACT

Introduction: mechanical metatarsalgias difficult to orthopedic treatment require surgical treatment. We report our experience with percutaneous surgery.
Objectivs: show the effectiveness of percutaneous distal osteotomy in the treatment of mechanical metatarsalgias.
Methods: a retrospective study of 100 patients undergoing mechanical metatarsalgias from January to December 2013, with an average age of 57 years. Minimum follow-up was 1 year of evolution. Mechanical metatarsalgias were classified according to the stage of walking, second and third rocker. It was clinically assessed the disappearance of plantar keratosis, plantar pain when walking, as well as abandoning previous templates. Radiographically the metatarsal formula and consolidation of the osteotomy were evaluated.
Results: in second rocker metatarsalgias, 90% had good or excellent results with 10% complications, mainly transfer metatarsalgia. In third rocker metatarsalgias 85% had good or very good results and 15% complications, mainly the transfer metatarsalgia.
Conclusions: percutaneous distal osteotomies appear to be an acceptable technique for mechanical metatarsalgias treatment to provide good clinical and radiological results. Learning curve is important since it is not free of complications.

REFERENCES

1. Viladot A. Patología del antepié. 3ra ed. Barcelona: Toray; 1984.

2. Llanos LF, Maceira E. Metatarsalgias. En: Manual SECOT de Cirugía Ortopédica y Traumatología. 2003. Ed. Panamericana. Cap. 60: 684-98.

3. Núñez Samper M, Llanos LF. Síndrome de insuficiencia del primer radio. En: Viladot A. Biomecánica, medicina y cirugía del pie. Cap 25. Barcelona: Iatros Ediciones S.L.; 1997.

4. Maestro M. Metatarsalgia of biomechanical origin treated with Weil osteotomy after planning of shortening. Consultado: 23 de enero de 2015. Disponible en: http://www.Afcp.comfr/weil_comfas_98. (1998)

5. Helal B. Metatarsal osteotomy for metatarsalgia. J Bone Joint Surg. 1975;57(B):187-92.

6. White DL. Minimal incision approach to osteotomies of the lesser metatarsals for treatment of intractable keratosis, metatarsalgia, and tailor’s bunion. Clin Podiatr Med Surg. 1991 Jan;8(1):25-39.

7. Leventen EO, Pearson SW. Distal metatarsal osteotomy for intractable plantar keratoses. Foot and Ankle. 1990 Apr; 10(5):247-51.

8. Trnka H-J, Nyska M, Parks BG, Myerson MS. Dorsyflexion contracture after the Weil osteotomy: results of cadaver study and tree-dimensional analysis. Foot Ankle Int. 2001 Jan;22(1):47-50.

9. Podskubka A, Stĕdrý V, Kafunĕk M. Distal shortening osteotomy of the metatarsals using the Weil technique: surgical treatment of metatarsalgia and dislocation of the metatarsophalangeal joint. Acta Chir Orthop Cech. 2002;69(2):79-84.

10. Trnka H-J, Mühlbauer M, Zettl R, Myerson MS, Ritschl P. Comparison of the results of the Weil and Helal osteotomies for the treatment of metatarsalgia secondary to dislocation of the lesser metatarsophalangeal joints. Foot Ankle Int. 1999 Feb;20(2):72-9.

11. Trnka H-J, Gebhard C, Mühlbauer M, Ivanic Gerd, Ritschl P. The Weil osteotomy for treatment of dislocated lesser metatarsophalangeal joints: good outcome in 21 patients with 42 osteotomies. Acta Orthop Scand. 2002 Apr;73(2):190-4.

12. Hofstaetter SG, Hofstaetter JG, Petroutsas JA, Gruber F, Ritschl P, Trnka H-J. The Weil osteotomy: a seven-year follow-up. J Bone Joint Surg. 2005 Nov;87(11);1507-11.

13. Prado M de, Ripoll PL, Golano P. Cirugía percutánea del pie. Técnicas quirúrgicas, indicaciones, bases anatómicas. España: Ed. Masson; 2003. p. 253. ISBN: 84-458- 1284-X

14. Prado M de, Ripoll PL. Cirugía percutánea del antepié. Monografías SECOT, Vol. 2. Barcelona: Masson; 2001.

15. Barouk LS. Die Metatarsalosteotomie nach Weil zur Behandlung der Metatarsalgie. Orthopade. 1996;2531:388-44