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Percutaneous Surgery for Static Metatarsalgia

  • Thomas BauerEmail author
Chapter

Abstract

Metatarsalgias with plantar hyperkeratosis under the metatarsal heads of the lateral rays is very prevalent. Conservative management with insoles often provides a complete or partial relief of the symptoms. In case of failure of non-operative modalities, surgery can be indicated, and several metatarsal osteotomies have been described. Their aim is to shorten and to raise the metatarsals to decrease the pressure under the metatarsal heads of the lateral rays to provide relief of the symptoms.1–12 The Weil osteotomy is the most popular distal metatarsal osteotomy and is still the gold standard treatment for metatarsalgia.5 However, metatarso-phalangeal joint stiffness is a very frequent complication after Weil osteotomy, and difficulties with fixation or restoration of the distal metatarsal arch can be experienced. We present a percutaneous procedure for the treatment of metatarsalgias with details on the surgical technique, first results and discussion of the benefits and indications.13–14

Keywords

Metatarsal Head Full Weight Bearing Gold Standard Treatment Metatarsal Osteotomy Cohesive Bandage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Feibel JB, Tisdel CL, Donley BD. Lesser metatarsal osteotomies. A biomechanical approach to metatarsalgia. Foot Ankle Clin. 2001 Sept;6:473–489.PubMedCrossRefGoogle Scholar
  2. 2.
    Leventen EO, Pearson SW. Distal metatarsal osteotomy for intractable plantar keratosis. Foot Ankle Int. 1987;10:247–251.CrossRefGoogle Scholar
  3. 3.
    Gauthier G. Maladie de Freiberg ou deuxième maladie de Koehler. Propositions dun traitement de reconstruction au stade évolué de laffection (34 cas traités). Rev Chir Orthop. 1974;60:337–341.PubMedGoogle Scholar
  4. 4.
    Kitaoka HB, Patzer GL. Chevron osteotomy of lesser metatarsals for intractable plantar callosities. J Bone Joint Surg (Br). 1998;80:516–518.CrossRefGoogle Scholar
  5. 5.
    Leemrijse T. Ostéotomie de Weil. In: Valtin B, Leemrijse T, ed. Chirurgie de lavant-pied. 2ème éd. Paris: Elsevier; 2005:126–141. Cahiers denseignement de la SOFCOT.Google Scholar
  6. 6.
    Wolf MD. Metatarsal osteotomy for the relief of painful metatarsal callosities. J Bone Joint Surg (Am). 1973;55:1760–1762.Google Scholar
  7. 7.
    Helal B. Metatarsal osteotomy for metatarsalgia. J Bone Joint Surg (Br). 1975;57:187–192.Google Scholar
  8. 8.
    Giannestras NJ. Plantar keratosis treatment by metatarsal shortening. J Bone Joint Surg (Am). 1966;48:72–76.Google Scholar
  9. 9.
    Giannestras NJ. Shortening of the metatarsal shaft in the treatment of plantar keratosis. An end-result study. Foot Ankle Int. 1995;16:529–534.PubMedCrossRefGoogle Scholar
  10. 10.
    Delagoutte JP, Jarde O. Ostéotomies métatarsiennes à lexception de la technique de Weil. In: Valtin B, Leemrijse T, ed. Chirurgie de lavant-pied. 2ème éd. Paris: Elsevier; 2005:149–152. Cahiers denseignement de la SOFCOT.Google Scholar
  11. 11.
    Denis A, Huber-Levernieux C, Goutallier D. Notre expérience de lostéotomie métatarsienne dans le traitement des métatarsalgies statiques. Méd Chir Pied. 1984;1:85–88.Google Scholar
  12. 12.
    Toullec E, Barouk LS, Rippstein P. Ostéotomie de relèvement basal métatarsienne BRT. In: Valtin B, Leemrijse T, ed. Chirurgie de lavant-pied. 2ème éd. Paris: Elsevier; 2005:142–148. Cahiers denseignement de la SOFCOT.Google Scholar
  13. 13.
    De Prado M, Ripoll PL, Golano P. Metatarsalgias. In: De Prado M, Ripoll PL, Golano P, ed. Cirurgia percutanea del pie. Barcelona, Spain: Masson SA; 2003:167–182.Google Scholar
  14. 14.
    Coillard JY, Laffenetre O, Cermolacce C et al. Traitement chirurgical des métatarsalgies statiques par technique percutanée. In: Valtin B, Leemrijse T, ed. Chirurgie de lavant-pied. 2ème éd. Paris: Elsevier; 2005:153–157. Cahiers denseignement de la SOFCOT.Google Scholar

Copyright information

© Springer London 2010

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryAmbroise Paré Hospital, West Paris UniversityBoulogneFrance

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