Percutaneous Treatment of Static Metatarsalgia with Distal Metatarsal Mini-invasive Osteotomy

Abstract

Metatarsalgia is frequent. Most patients respond to 6–12 months of conservative management. At times, usually from structural abnormalities of the foot, especially first-ray shortening, surgery provides considerable benefit. Historically, the first osteotomies described to manage metatarsalgia were diaphyseal (Meisenbach 1916; Giannestras 1954; Helal 1975), then proximal metaphyseal (Mau 1940; Sgarlata 1979; Delagoutte 1990), and finally distal (Borrgreve 1949; Davidson 1969; Gauthier 1970). In 1991, Weil [1] described a technique, still widely used in Europe, which enables perfect control of the planned proximal migration of the metatarsal head. Consolidation is ensured by appropriate internal fixation. The technique, however, involves penetrating the metatarso-phalangeal joint, and frequently causes stiffening of the metatarso-phalangeal joint.