Osteotomia proximal dos metatarsos com fixação para o tratamento das metatarsalgias

Abstract

Objective: Evaluate the outcomes of the proximal osteotomies in the metatarsal bone, with shortening and/or lifting of the metatarsal head, analysing pain and fuction,with other associated pathologies. Methods: We have treated twenty two patients (29 feet) from november 2002 to november 2014, being 13 right and 16 left foot. Mean age was 52.8 years (range 21-85), four males and twenty-five females, with a mean follow-up of 73 months (range 7-150). Patients were treated with proximal end metatarsal osteotomies that were secure with wires metal, staples or compression plates for fixation. Simultaneous phatologies treated were hallux valgus deformity, splay foot, hallux rigidus, pes cavus, hammer toes, crossover toes and plantar plate repair. Patients were evaluate with the American Orthopedic Foot Society (AOFAS). Results: Surgical treatment resulted in biomechanical stability of tha foot, balance of the transverse arch and reduction of the metatarsalgia symptoms. AOFAS score for smaller fingers presented a mean of 34.5±12.5 preoperative and 88.9±7.9 postoperative (P<0.0001). One patient developed a late infection, that was treated with antibiotics. Conclusion: Proximal osteotomies in the metatarsal bone with fixation for the treatment of metatarsalgia resulted in a regression of symptoms in 96% of the npatients treated with this procedure.