title: Proximal dome-shaped osteotomy for symptomatic bunionette.
abstract: The results of a dome-shaped osteotomy of the proximal third of the fifth metatarsal in patients with symptomatic bunionette deformity were reviewed. The series was comprised of eight patients (10 feet; mean age of patients, 21 years). The average followup was 30 months. All patients were free from pain at the fifth metatarsophalangeal joint and were satisfied with the results of this procedure. The mean angle between the longitudinal axes of the fifth metatarsal and the proximal phalanx was 18.9 degrees before surgery and 2.6 degrees after surgery. The mean angle between the longitudinal axes of the fourth and fifth metatarsals was 12.2 degrees before surgery and 4.8 degrees after surgery. The overall results were good in all 10 feet. Three feet had delayed union at the osteotomy site, but union was obtained in all feet. The osteotomy site of the fifth metatarsal in feet with delayed union was more proximal than that of the other feet. Therefore, proximal osteotomy of the fifth metatarsal should be done not at the base, but at the proximal site of the diaphysis to prevent delayed union. A proximal dome-shaped osteotomy corrects the deformity and relieves the symptoms, but careful attention should be paid to the osteotomy site.
authors.affiliation: Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Okuda
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Junichi
authors.initials: J
authors.lastname: Morikawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Jotoku
authors.forename: Muneaki
authors.initials: M
authors.lastname: Abe
mesh_terms: D000293:Adolescent; D000328:Adult; D001864:Bone Wires; D002648:Child; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000473:pathology; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications; D011859:Radiography; D014945:Wound Healing