Effect of plantar incision for metatarsal head resection arthroplasty of the small toes

Abstract

Objective: To evaluate the clinical outcome of metatarsal head resection arthroplasty of the small toes using a plantar approach in patients with severe forefoot deformities. Methods: Twelve patients (15 feet), 10 females and two males, age 53 to 81 years old, with diabetes and rheumatoid arthritis were evaluated
between January 2014 and September 2017. All patients underwent the same surgical technique – metatarsal head resection arthroplasty of the small toes via a plantar approach. The evaluation was based on pain according to the visual analogue scale, the type of footwear used and the index of patient satisfaction with the surgery. Results: In the series studied, all 12 patients (15 feet) presented significant pain improvement. Regarding wound healing, only one patient had a calloused scar, but without painful or functional impairment. Eleven individuals (14 feet) could wear all types of footwear, and only one had to
use custom footwear. Conclusion: Metatarsal head resection arthroplasty of the smaller toes using a plantar approach is a safe, reliable and effective technique for the treatment of patients with severe forefoot deformities. 

Level of Evidence IV; Therapeutic Studies, Case series.