СРАВНИТЕЛЬНАЯ ХАРАКТЕРИСТИКА ДИСТАЛЬНЫХ ОСТЕОТОМИЙ СРЕДНИХ ПЛЮСНЕВЫХ КОСТЕЙ ПРИ МОЛОТКООБРАЗНОЙ ДЕФОРМАЦИИ ПАЛЬЦЕВ СТОПЫ И ЦЕНТРАЛЬНОЙ МЕТАТАРЗАЛГИИ

Abstract

Aim of the study. To compare the effectiveness of distal extension-shortening osteotomy (DESO) of the metatarsals and Weil-osteotomy in the surgical treatment of the middle hammer toe deformity and central metatarsalgia. Treatment outcomes were studied in 80 patients (75 women and 5 men) aged 31 to 79 years (median – 57 [52; 64] years) on 90 feet. The patients were divided into 2 groups: the study group – 32 people, where the DESO was used, and the comparison group – 48 people, in which a typical Weil-osteotomy was performed. Long-term results were studied within 6 to 46 months (median – 24 [10; 33] months). During the examination, a variant of hammertoe deformity was determined, radiometric parameters of the forefoot were measured, the Visual Analogue Scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society Lesser Toe Scale (AOFAS—II—V) were used. After surgery in the study group, the median VAS decreased to 1 [0; 1] points (p < 0,001), in the comparison group — up to 2 [0; 3] points (p < 0,001). Median AOFAS—II—V in the study group increased by 2,2 times and reached 93 [90; 95] points (p < 0,001), in the comparison group it increased only to 85 [73; 90] points (p < 0,001). The received data indicate a higher efficiency of DEMO for hammer toe deformity and central metatarsalgia compared to the standard Weil-osteotomy. The DEMO technique provides a pronounced reduction in pain syndrome (by 6 times), creates conditions for easy elimination of hammer toe deformity, improves the functional state of the forefoot by more than 2,2 times (according to AOFAS—II—V) and obtains positive treatment outcomes in 94,4 % of cases.