Asymmetric "V" osteotomy: a predictable surgical approach for chronic central metatarsalgia

Area of Science:

• Orthopedic surgery
• Podiatric medicine
• Foot and ankle surgery

Background:

• Chronic metatarsalgia presents significant treatment challenges.
• Past surgical approaches often resulted in complications like stress fractures and adjacent metatarsalgia.
• A deeper understanding of the metatarsal parabola is crucial for effective treatment.

Purpose of the Study:

• To analyze existing surgical approaches for chronic metatarsalgia.
• To present a novel and predictable surgical technique for correcting metatarsal parabola abnormalities.
• To reduce excessive plantarflexion of metatarsals and associated pathologies.

Main Methods:

• The study introduces the asymmetric "V" osteotomy technique.
• The senior author has performed this procedure on 30 patients (40 metatarsals).
• A postoperative follow-up period of 12 to 18 months was conducted.

Main Results:

• No significant complications such as recurrences, transfer lesions, or malunions were reported.
• Two cases of delayed union with secondary bone callus were observed.
• The technique demonstrated predictability and enhanced metatarsal parabola correction.

Conclusions:

• The asymmetric "V" osteotomy is an innovative approach for structural metatarsal abnormalities.
• This technique offers advantages over previous osteotomies, including better predictability and anatomic reduction.
• The procedure promotes primary bone healing and allows for a faster return to normal activities.