Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy of the Lesser Toes: Learning Curve
| Autor: | Hans-Joerg Trnka, Clemens Mansfield, Peter Bock, S. Krenn, Michel Chraim, Sascha Albers |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Metatarsalgia
Male Metatarsophalangeal Joint medicine.medical_specialty medicine.medical_treatment Treatment outcome Osteotomy Severity of Illness Index Cohort Studies 03 medical and health sciences Surgical time 0302 clinical medicine Medicine Humans Minimally Invasive Surgical Procedures Orthopedics and Sports Medicine Podiatry Range of Motion Articular Pedobarography Metatarsal Bones Aged Pain Measurement Retrospective Studies Weil osteotomy 030222 orthopedics business.industry 030229 sport sciences Middle Aged Toes medicine.disease Surgery Radiography Treatment Outcome Invasive surgery Female Metatarsal bones business Learning Curve Follow-Up Studies |
| Zdroj: | Footankle specialist. 11(3) |
| ISSN: | 1938-7636 |
| Popis: | Background. Minimally invasive surgery has a shorter surgical time, and in this study we focus on minimally invasive distal metatarsal metaphyseal osteotomy (DMMO). The operation seems to be less complex but requires a high learning curve. We report on our first patients to underline the need for extensive training and great awareness for the risks in the early learning stages. Methods. We evaluated 27 patients (mean age = 60.9 years) with a mean follow-up time of 7.2 months. Indication was metatarsalgia, intractable plantar keratosis, and the (sub-)luxation of the metatarsophalangeal joint. Clinical results were evaluated with the 12-item Short Form (SF-12), Foot Function Index (FFI), Foot and Ankle Ability Measure (FAAM), and the American Orthopaedic Foot and Ankle Score (AOFAS). Radiographs and pedobarographic analysis were obtained. Results. Scores ranged closely to standard value (AOFAS 88.07 points; FFI 93%; FAAM 36.4 points; SF-12 31.27 points). Pedobarography showed significant differences in several forefoot areas. We encountered nonunion/malunion and necrosis of the metatarsal head. Conclusions. The aim of this study was to demonstrate the need for intensive training before practicing DMMO. Results show that minimally invasive DMMO requires a high learning curve. Correct handling of the burr is associated with a lot of training. Wrong handling can lead to nonunion/malunion or necrosis. Levels of Evidence: Therapeutic, Level IV: Case series |
| Databáze: | OpenAIRE |
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