Clinical and Radiographic Outcomes of Distal Metatarsal Metaphyseal Osteotomy for Central Primary Metatarsalgia
Clinical and Radiographic Outcomes of Distal Metatarsal Metaphyseal Osteotomy for Central Primary Metatarsalgia
The primary propose of this prospective study is to specifically evaluate the safety and
 effectiveness of Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy (DMMO) in
 treating patients with persistent central primary metatarsalgia, associated or not to hallux
 valgus and lesser toe deformities, identifying possible contraindications in relation to some
 demographic parameters (age, gender, BMI, and smoking). The second objective is to verify the
 potential of DMMO in restoring a harmonious foot morphotype according to Maestro's criteria
 and if these radiographic parameters are correlated with clinical outcomes, maintaining the
 predictive value of these criteria during preoperative planning also for this percutaneous
 surgery.
A consecutive series of patients with metatarsalgia is consecutively enrolled and treated by
 DMMO. According to Maestro criteria, pre-operative planning is carried out by both clinical
 and radiological assessment. Patient demographic data, AOFAS scores, 17-Foot Functional
 Index, Manchester-Oxford Foot Questionnaire, SF-36, VAS, and complications are recorded.
 Maestro parameters, relative morphotypes, and bone callus formation are assessed. Statistical
 analysis is carried out (p < 0.05).
Inclusion Criteria:

 -  forefoot persistent pain;

 -  presence or not of forefoot plantar hyperkeratosis lesions;

 -  ineffective conservative and orthotic treatment performed for at least 6 months.

 Exclusion Criteria:

 -  arthritis and stiffness of MTP joint;

 -  congenital deformities of the foot;

 -  hallux rigidus;

 -  Freiberg infraction;

 -  Morton's neuroma;

 -  diagnosis of rheumatic, metabolic, neurologic, infective, or psychiatric pathologies;

 -  previous trauma;

 -  foot and ankle surgery,

 -  any form of secondary or iatrogenic metatarsalgia.