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. 2024 Apr 10;13(8):2180.
doi: 10.3390/jcm13082180.

Impact of Minimally Invasive Intra-Capsular Metatarsal Osteotomy on Plantar Pressure Decrease: A Cross-Sectional Study

Carlos Fernández-Vizcaino  1 , Carmen Naranjo-Ruiz  1 , Nadia Fernández-Ehrling  1 , Sergio García-Vicente  2 , Eduardo Nieto-García  1 , Javier Ferrer-Torregrosa  1
Affiliations

Impact of Minimally Invasive Intra-Capsular Metatarsal Osteotomy on Plantar Pressure Decrease: A Cross-Sectional Study

Carlos Fernández-Vizcaino et al. J Clin Med. .

Abstract

Background: Metatarsalgia is a common pathology that is initially treated conservatively, but failure to do so requires surgery, such as the minimally invasive distal metatarsal osteotomy (DICMO). Methods: In this prospective study of 65 patients with primary metatarsalgia who underwent DICMO, plantar pressures, American Orthopaedic Foot and Ankle Society MetaTarsoPhalangeal-InterPhalangeal scale (AOFAS-MTP-IP) and Visual Analog Scale (VAS) were evaluated pre-operatively and post-operatively and there was a subgroup in which an inclinometer was used to observe the importance of the inclination of the osteotomy. Results: The results show a significant reduction in plantar pressures after DICMO surgery without overloading the adjacent radii, especially in the subgroup with an inclinometer to guide the osteotomy. The AOFAS-MTP-IP scale evidenced a marked improvement in metatarsal function and alignment with scores close to normal. The VAS scale showed a substantial decrease in pain after DICMO osteotomy. Conclusions: DICMO, with an inclinometer for a 45° osteotomy, proved to be a safe and effective procedure for primary metatarsalgia, although further comparative studies are needed to confirm its superiority.

Keywords: DICMO; inclinometer; metatarsalgia; minimally invasive; osteotomy; plantar pressures.

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Conflict of interest statement

None of the authors had any financial, personal, or professional conflicts of interest in relation to the results of this study.

Figures

Figure 1
Figure 1
Flow diagram of the selection process and analysis of the participants included in the present study.
Figure 2
Figure 2
Metatarsal surgery (DICMO) (A) Motor inclination (B) Dorsoplantar Fluoroscopy 2nd and 3rd metatarsal (C) Oblique Fluoroscopy 3rd metatarsal.
Figure 3
Figure 3
A goniometer incorporated to the surgical micromotor sends the data to a mobile phone via Bluetooth.
Figure 4
Figure 4
A Static plantar pressure analysis using Medicapteurs® S-Plate (Balma, France).
Figure 5
Figure 5
Decrease in plantar pressures in each of the groups with and without goniometer. (A) Without goniometer, (B) With goniometer.
See this image and copyright information in PMC

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