Metatarsal osteotomy using a double-threaded compression screw: an adjunct to revision forefoot surgery

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Surgical Innovation

Background:

• Metatarsal osteotomies and nonunions present complex surgical challenges.
• Previous surgeries and symptomatic conditions often complicate treatment.
• Effective internal fixation is crucial for successful osteotomy healing and nonunion repair.

Purpose of the Study:

• To evaluate the efficacy of the Herbert screw for internal fixation in metatarsal neck osteotomies.
• To assess the outcomes of Herbert screw fixation in nonunion repairs of the metatarsals.
• To analyze the use of Herbert screws in patients with prior surgical history and complex foot conditions.

Main Methods:

• A retrospective review of 16 patients (18 feet) treated with Herbert screws.
• Internal fixation of 20 primary or revision lesser metatarsal osteotomies.
• Repair of six metatarsal nonunions with screw fixation and bone grafting.

Main Results:

• The Herbert screw was utilized for internal fixation in metatarsal osteotomies and nonunion repairs.
• The study included patients with complex histories, including previous surgeries and symptomatic conditions.
• Follow-up averaged 14 months, assessing the outcomes of the surgical interventions.

Conclusions:

• The Herbert screw serves as a viable option for internal fixation in metatarsal osteotomies and nonunion repairs.
• This fixation method was applied to a cohort with significant pre-existing foot pathology and surgical history.
• Further investigation may be warranted to establish long-term outcomes and compare with other fixation techniques.