Percutaneous Distal Osteotomies of the Metatarsal Bones: Surgical Technique and Results

Objective: This study presents clinical and radiological outcome of a percutaneous technique for the correction of hallux valgus and lesser toe deformities. Methods: We present a 36 months follow-up series of 32 patients who have been treated with the Reverdin- Isham osteotomy for the correction of hallux valgus, and a percutaneous technique for the correction of lesser toes deformities and metatarsalgia. Clinical outcome data were recorded with the AOFAS score. Radiologic evaluation consisted of weight bearing (AP, lateral and Walter-Muller) views pre and postoperatively at 6 weeks, 3, 6, 12 and 36 months after surgery. Results: At three year follow-up, the mean difference of the HVA was 9.2 (p<0.0001), of the IMA was 0.4 (p<6719), and the mean difference of the PASA was 15.9 (p<0.001). The AOFAS rose from 48.4 to 87.6. Most encountered complication was oedema that lasted for 6 months, especially in the patients who underwent the Weil osteotomy of II, III and IV metatarsal bone head for the treatment of metatarsalgia. Conclusion: Many minimal invasive techniques are becoming more and more recognized, with some indisputable advantages but also not free of objective difficulties. We believe that percutaneous distal metatarsal bone osteotomy represents a good option for the treatment of mild- to moderate hallux valgus, lesser toes deformities and metatarsalgia.