Treatment of metatarsalgia by neck shortening osteotomy and intramedullary fixation (NESHOIF): a pilot study

Abstract

Objective: Neck shortening osteotomy is a common treatment for metatarsalgia. The goal of this pilot study was to present the clinical and radiological results of neck shortening osteotomy and intramedullary fixation. Methods: Seven patients (nine feet) were treated for metatarsalgia by neck shortening osteotomy and intramedullary fixation and evaluated retrospectively after a follow-up period of at least 2 years. All patients underwent preplanned concomitant procedures. Pre- and postoperative American Orthopaedic Foot & Ankle Society (AOFAS) scores were compared, and union was assessed on the 6th, 10th and 14th postoperative weeks. Results: Radiographic union was observed on the 6th week of followup in all but one patient, who underwent shock wave treatment on the 10th postoperative week and had X-ray evidence of union after 4 weeks. The AOFAS scores improved by an average of 52 points after the procedure (mean pre- and postoperative scores were 41 and 93, respectively). All patients were satisfied with the procedure and said they would have it again under the same circumstances. Conclusion: Neck shortening osteotomy and intramedullary fixation appeared to be a simple and effective treatment for metatarsalgia, with few associated complications. Level of Evidence: IV – case series