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Distal Metatarsal Minimally Invasive Osteotomy (DMMO): Surgical technique, variants, indications, and treatment decision-tree.

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BACKGROUND Metatarsal osteotomy is a major means of treating mechanical metatarsalgia. Open techniques are widely used, and notably that described by Weil. They have, however, certain drawbacks, and new types… Click to show full abstract

BACKGROUND Metatarsal osteotomy is a major means of treating mechanical metatarsalgia. Open techniques are widely used, and notably that described by Weil. They have, however, certain drawbacks, and new types of osteotomy have been developed. Percutaneous techniques are presently very much in favor, and Distal Metatarsal Minimally Invasive Osteotomy (DMMO) has emerged as a treatment for metatarsalgia. Although very widely used, it is poorly codified in the literature. METHOD The present study detailed DMMO techniques and their variants (oblique and reverse), with corresponding indications and treatment decision-tree. RESULTS Initial findings seem encouraging, with functional results comparable to those of open surgery. Postoperative edema and radiologic bone healing time seem to be longer in DMMO. There is, on the other hand, no difference regarding stiffness. CONCLUSION DMMO is an effective option to treat metatarsalgia, with variants enabling adaptation to foot morphology, but needing confirmation by studies with higher levels of evidence.

Keywords: distal metatarsal; minimally invasive; metatarsal minimally; treatment; metatarsal; invasive osteotomy

Journal Title: Foot
Year Published: 2021

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