Midshaft metatarsal segmental osteotomy with open reduction and internal fixation

Area of Science:

• Orthopedic surgery
• Foot and ankle surgery
• Podiatric medicine

Background:

• Metatarsalgia presents significant patient discomfort with diverse causes.
• Lesser metatarsal osteotomy is a treatment for persistent metatarsalgia.
• Optimal osteotomy location and type for lesser metatarsals are debated.

Purpose of the Study:

• To report initial outcomes of midshaft segmental osteotomy for lesser metatarsals.
• To evaluate open reduction and internal fixation in this procedure.

Main Methods:

• Retrospective review of 95 patients (102 feet, 126 osteotomies) undergoing midshaft segmental osteotomy.
• Follow-up ranged from 5 to 18 months (average 8.8 months).
• Fixation utilized a 1/4-tubular plate and 2.7-mm cortical screws.

Main Results:

• Achieved an excellent bony union rate of 99.2% (125/126 osteotomies).
• One nonunion (0.8%) occurred, which united after hardware removal.
• Five patients developed transfer lesions within the follow-up period.

Conclusions:

• Midshaft segmental osteotomy is a viable technique for lesser metatarsal shortening.
• The procedure demonstrates a high rate of bony union.
• Further clinical investigation on patient outcomes is warranted.