title: Helal metatarsal osteotomy for the treatment of metatarsalgia: a critical analysis of results.
abstract: We reviewed the results of treatment of 114 feet in 96 patients with pressure metatarsalgia treated with a metatarsal osteotomy performed according to the technique of Helal. Clinical examination was performed according to a standardized evaluation questionnaire using the American Orthopaedic Foot and Ankle Society Lesser Metatarsophalangeal-Interphalangeal Scale. The results were correlated with number of metatarsal osteotomies, the length of the follow up, the age of the patient, and type of additional procedures performed. Sixty-one percent of the patients rated the operation as excellent or good. Patient age and number of osteotomies did not influence the results; however, the length of time following surgery and associated Keller-Brandes resection arthroplasty influenced the outcome negatively. There was a high incidence of increased transfer of weight to adjacent metatarsals. We concluded that the Helal type metatarsal osteotomy is unlikely to predictably achieve symptom relief over a long period.
authors.affiliation: Department of Orthopaedics, Gersthof Hospital, Vienna, Austria.
authors.forename: H J
authors.initials: HJ
authors.lastname: Trnka
authors.forename: B
authors.initials: B
authors.lastname: Kabon
authors.forename: R
authors.initials: R
authors.lastname: Zettl
authors.forename: A
authors.initials: A
authors.lastname: Kaider
authors.forename: M
authors.initials: M
authors.lastname: Salzer
authors.forename: P
authors.initials: P
authors.lastname: Ritschl
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000379:methods; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008684:Metatarsus / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome