Proximal metatarsal resection

Abstract 

Objective

The purpose of proximal tarso-metatarsal joint resection is to provide early weight-loading for biomechanical realignment and correct weight imbalance across the MTP joint. Therefore, its main indications are all those metatarsalgia in which previous orthopaedic treatment has failed.

Material and methods

We report our experience in metatarsalgia management with proximal metatarsal resection. This is a retrospective study between April 1997 and December 2005. 40 feet underwent this procedure (36 patients), with a total report of 86 osteotomies. Clinical results were evaluated with American Orthopaedic Foot and Ankle Society Lesser Metatarsophalangeal-Interphalangeal Scale Score (maximum score: 100 points).

Results

A 10–15-grade correction was achieved with a mean resection of 2mm. Assessment with AOFAS’ scale disclosed previous average 35.75±4.2 with a final score reported of 88.4±6.9 (range 65–100). An overall mean increase of 52.65 points was achieved. No case had major complications that required further surgery. Pain improved in 39 patients (97.5%), and persisted in one patient.

Conclusions

Proximal metatarsal resection is a simple technique that provides adequate correction of the abnormal pressure distribution across the MTP joint without internal fixation.

Keywords: Metatarsalgia, Proximal, Metatarsal resection