The purpose of this study is to evaluate the results of distal osteotomy of lesser metatarsals carried out through a percutaneous technique.
Forty-four feet in 37 patients were reviewed, which the same surgeon had subjected to 110 percutaneous osteotomies between November 2002 and July 2006. Metatarsalgias of general or traumatic origin were excluded from the study. All patients were assessed functionally (by means of the AOFAS [American Orthopaedic Foot and Ankle Society] Lesser Metatarsophalangeal-Interphalangeal Scale) and radiographically.
After a mean 15-month?follow-up, a satisfactory functional result was obtained in 93.2 % of cases (41 feet), with a mean final score of 91 (range: 65?00) on the AOFAS scale. The condition recurred in 5 patients, and 2 developed transfer metratarsalgia (these required an osteotomy of the affected metatarsals). Mobility of the metatarsophalangeal (MTP) joint was not significantly disturbed in any of the cases and 7 patients developed a ¡°floating toe?deformity. Radiologically a mean shortening of 2.9 mm was observed. There were 3 cases of delayed healing, but eventually healing was achieved by all patients.
Percutaneous osteotomy affords satisfactory clinical and cosmetic results and leads to no problems in terms of healing or MTP joint stiffness. These results indicate that it is an effective and safe surgical technique that can be recommended for lesser ray metatarsalgia, whether in association with other forefoot procedures or not.