title: A new elevating metatarsal osteotomy: geometrical design and applications.
abstract: For metatarsalgia and lesser toe deformities, a commonly performed procedure is the Weil osteotomy, which inevitably depresses the metatarsal head, changing the intrinsic muscle axis and generating phalanx extension. The objective of this study is to present a new metatarsal osteotomy that shortens or lengthens and elevates the metatarsal head, the elevating metatarsal osteotomy (EMO), with its geometrical analysis and possible applications. A geometrical model was designed, planning an oblique subcapital osteotomy with slice resection and distal displacement. A trigonometric analysis was done to calculate how to shorten, elevate, or lengthen the metatarsal head. The EMO elevates the head in one-third of the width of the resected slice. Distal and dorsal displacement of the metatarsal head results in an elevation and lengthening of the metatarsal bone (60% elevation and 65% lengthening). Performing an elevating metatarsal osteotomy will lengthen and elevate the metatarsal head, which sometimes is necessary when treating toe deformities and instability.
authors.affiliation: Unidad de Tobillo y pie, Clïnica Alemana, Santiago, Chile.
authors.forename: Emilio
authors.initials: E
authors.lastname: Wagner
authors.forename: Cristián
authors.initials: C
authors.lastname: Ortiz
authors.forename: Andrés
authors.initials: A
authors.lastname: Keller
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Espinosa
authors.forename: Sergio
authors.initials: S
authors.lastname: Arellano
authors.forename: Paulina
authors.initials: P
authors.lastname: de la Fuente
authors.forename: Pablo
authors.initials: P
authors.lastname: Wagner
mesh_terms: D005530:Foot Deformities / Q000601:surgery; D006801:Humans; D008682:Metatarsal Bones / Q000601:surgery*; D037061:Metatarsalgia / Q000601:surgery; D010027:Osteotomy / Q000379:methods*