[Clinical results of treatment of mechanical metatarsalgia without first metatarsal involvement]

To analyze the clinical results of metatarsalgia treated with percutaneous distal metatarsal metaphyseal osteotomies (DMMO).

Prospective and continuous study of 29 patients with isolated unilateral mechanical metatarsalgia, operated on with DMMO, with a mean follow-up of 38 months. The mean age of the patients was 58 (range: 50-67) years and only two men. We use the AOFAS score, we obtained the digital and metatarsal formulas on the X-rays. We record the subjective assessment of the surgeon and the patient at the end of the treatment.

The improvement in the final score exceeded 80 points in all cases (p = 0.000), with a significant improvement in pain (p = 0.000) and calluses (p = 0.000), improving metatarsal-phalangeal joint stability and interphalangeal and metatarsal alignment. The type of footwear did not change after surgery, we found no variation in mobility, neither in the metatarsophalangeal joints (p = 0.382), nor in the interphalangeal joints (p = 0.672). After surgery increased the square foot morphology (p = 0.027) but the metatarsal formula underwent few modifications. Patients and surgeons were in 96% of the cases "very satisfied" or "satisfied".

DMMO achieves a high degree of satisfaction in patients and in the surgeon, pain and hyperkeratosis under the head of the painful metatarsals disappear and that significantly improves the functional capacity of patients.