Telescoping osteotomy for pressure metatarsalgia

Abstract

A review is presented of 508 feet in 310 patients after telescoping osteotomy of the lesser metatarsals for metatarsalgia. The patients were predominantly female (80%), with a mean age of 55 years; the range of follow-up was 1 to 12 years. In 22% of the patients the metatarsalgia was associated with rheumatoid arthritis. Improvements in assessment and modifications in technique are reported and the management of complications is discussed. The results show that telescoping osteotomy for established cases of pressure metatarsalgia is a simple and reliable operation. Permanent relief of symptoms can be expected in over 80% of patients.

The Weil osteotomy for treatment of dislocated lesser metatarsophalangeal joints: Good outcome in 21 patients with 42 osteotomies

“…Preoperatively 23 of 32 MTP joints were diagnosed as dislocated and correction was obtained in 5 of 32 at follow-up. Helal and Greiss (1984) noted successful reduction of pain in 88%, but this has not been con rmed by others. Winson et al (1988) obtained good pain reduction in 47%, and Mulier et al (1994) had good results in only 50%.…”

“…Two of the screws and all migrated K-wires had to be removed. Helal and Greiss (1984) suggested that shortening of the metatarsal without touching the joint capsules would allow passive correction of the subluxation or dislocation. Mulier et al (1994) and Winson et al (1988) found that this is not correct.…”

“…Surgical options include dorsal soft tissue release with pin-xation (Scheck 1968, Thompson and Hamilton 1987, Coughlin 1989, silicone implants (Cracchiolo et al 1988), metatarsal neck osteotomies (Helal 1975, Helal and Greiss 1984, Trnka et al 1996 and MTP joint excisional arthroplasties (DuVries 1956). Weil devised a joint preserving, intraarticular shortening osteotomy, rst reported by Barouk (1996).…”

Der infizierte rheumatische Vorfu�?wie viel Chirurgie ist sinnvoll?

“…Der rheumatische Vorfuß ist ein in der Literatur häufig behandeltes Problem (3)(4)(5)(6)(7)(14)(15)(16). Infekte in diesem Bereich sind sehr ernst zu nehmen, da sie auf umgebende Weichteil-und Knochenareale über-greifen können.…”

Technique Using Interference Fixation Repair for Plantar Plate Ligament Disruption of Lesser Metatarsophalangeal Joints

“…Surgical repair of plantar plate ligament disruption has evolved with increasing appreciation of the anatomy of the MTPJ (7,8). Primary repairs that involve direct visualization of the plantar plate injury through dorsal and plantar incisional approaches have been described (9)(10)(11)(12), and procedures aimed at restoring MTPJ stability have been reported with the use of anchors (10), extensor tendon lengthening (13,14), flexor tendon transfers (14)(15)(16)(17), crossover second toe repair (14,16), metatarsal osteotomy (11,18,19), and total joint implantation (20). However, considerable controversy still exists regarding the optimal operative intervention for this pathologic entity (12,17).…”