Sliding oblique versus segmental resection osteotomies for lesser metatarsophalangeal joint pathology.
BACKGROUND
Oblique shortening osteotomy (Weil) can address lesser MP pathology but can have a high rate of complications. The purpose of this study was to review the results of a modification of the Weil osteotomy, the segmental resection metatarsal osteotomy.


METHODS
Between 2004 and 2006, 48 patients underwent the segmental resection osteotomy with a mean followup of 13 (range, 6 to 26) months. All the patients were evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score and a questionnaire addressing distances they were able to walk, work limitations, sporting activity, and overall satisfaction.


RESULTS
The postoperative AOFAS forefoot score was an average of 87.6 (range, 59 to 100; SD, 10.97) and the overall satisfaction rate was 85.4%. The complication rate was 18.8% for transfer metatarsalgia, 27.1% for floating toes, 35.4% for toe weakness, 14.6% for infection, and 10.4% for wound healing problems.


CONCLUSIONS
Despite the complications, the patients who underwent segmental osteotomy were satisfied with the outcome for lesser MTP joint pain and deformity. This is a preliminary study with significant refinement of the operative method as detailed in the surgical technique section. Further followup will elucidate whether additional changes are necessary in the surgical technique.
Los Angeles, CA, USA.
Rishi
R
Garg
David B
DB
Thordarson
Mark
M
Schrumpf
Deborah
D
Castaneda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016916:Joint Deformities, Acquired / Q000601:surgery; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome