Distal metatarsal osteotomy for intractable plantar keratoses

Area of Science:

• Orthopedic Surgery
• Podiatric Medicine
• Surgical Innovation

Background:

• Intractable plantar keratosis (IPK) and metatarsalgia significantly impact patient quality of life.
• Conservative treatments for IPK and metatarsalgia are often insufficient.
• Surgical intervention is frequently required for persistent cases.

Purpose of the Study:

• To present a straightforward surgical technique: distal osteotomy of the metatarsal necks.
• To evaluate the efficacy of this procedure in patients with IPK and metatarsalgia.
• To establish a treatment algorithm guiding metatarsal selection for osteotomy based on keratosis location.

Main Methods:

• A cohort of 21 feet diagnosed with IPK causing metatarsalgia underwent distal osteotomy.
• Follow-up averaged 31 months post-surgery.
• A specific treatment plan was implemented, determining which metatarsals to osteotomize based on the plantar keratosis location.

Main Results:

• The study details the outcomes of the distal osteotomy procedure.
• Complications associated with the surgical technique are reported.
• The effectiveness of the treatment plan in alleviating symptoms is discussed.

Conclusions:

• Distal osteotomy of the metatarsal necks is a relatively simple and effective surgical option for IPK and metatarsalgia.
• The presented treatment plan provides a structured approach to surgical decision-making.
• Further evaluation of outcomes and complications supports its clinical application.