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Geometric Assessment and Tissue Damage Control in Anatomically, Ultrasonographically, and Fluoroscopically Guided Intracapsular DICMO Osteotomies Conducted on Cadaveric Specimens.

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Predictive Measurement for Windlass Change in Length and Selected Treatment Outcomes in Chronic Plantar Fasciitis
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Impact of Minimally Invasive Intra-Capsular Metatarsal Osteotomy on Plantar Pressure Decrease: A Cross-Sectional

Carlos Fernández-Vizcaino1, Carmen Naranjo-Ruiz1, Nadia Fernández-Ehrling1

  • 1Podiatry Department, Faculty of Medicine and Health Sciences, Valencia Catholic University "San Vicente Mártir", 46001 Valencia, Spain.

Journal of Clinical Medicine
|April 27, 2024
PubMed
Summary

Minimally invasive distal metatarsal osteotomy (DICMO) effectively reduces pain and improves function for metatarsalgia. This surgical technique, especially with inclinometer guidance, shows promising results in reducing plantar pressure.

Keywords:
DICMOinclinometermetatarsalgiaminimally invasiveosteotomyplantar pressures

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Area of Science:

  • Orthopaedic Surgery
  • Podiatry
  • Biomechanics

Background:

  • Metatarsalgia is a prevalent foot condition often requiring surgical intervention when conservative treatments fail.
  • Minimally invasive distal metatarsal osteotomy (DICMO) is a surgical option for recalcitrant metatarsalgia.

Purpose of the Study:

  • To evaluate the efficacy of DICMO for primary metatarsalgia.
  • To assess the impact of DICMO on plantar pressures, foot function, and pain levels.

Main Methods:

  • A prospective study involving 65 patients undergoing DICMO for primary metatarsalgia.
  • Pre- and post-operative evaluation of plantar pressures, AOFAS-MTP-IP scale, and VAS.
  • Subgroup analysis using an inclinometer to guide osteotomy angle.

Main Results:

  • DICMO significantly reduced plantar pressures without overloading adjacent metatarsals.
  • The AOFAS-MTP-IP scale indicated marked improvement in metatarsal function and alignment.
  • A substantial decrease in pain was observed, as measured by the VAS scale.

Conclusions:

  • DICMO, particularly with a 45° osteotomy guided by an inclinometer, is a safe and effective treatment for primary metatarsalgia.
  • Further comparative studies are recommended to establish the superiority of this technique.