419 Medium- Long Term Clinical Outcome of Distal Metaphyseal Metatarsal Osteotomy (DMMO) for Lesser Toe Metatarsalgia

Abstract

Abstract Aim The surgical management of metatarsalgia is usually with an intra-articular Weil’s type of metatarsal osteotomy. Minimally invasive surgery has become increasing successful for a variety of forefoot conditions. Performing a distal metaphyseal metatarsal osteotomy to decompress the affected ray may result in substantial improvement to quality of life. The aim of this study was to evaluate the outcome of patients following minimally invasive distal metaphyseal metatarsal osteotomy surgery (DMMO). Method This is a single-centre consecutive series of 12 patients who underwent DMMO. The aim was to decompress the affected rays and restore metatarsal parabola. DMMO was performed under image intensifier, using burrs inserted via stab incisions. Clinical data was recorded and pre-operatively and immediately post operatively Manchester-Oxford Foot Questionnaire (MOXFQ) scores were collected. Another MOXFQ score was then collected with a minimum follow-up period of 12 months to ascertain is scores had improved in the interim. Results Average age of patients was 57years. The sex ratio was M:F 8:4. The average pre-operative MOXFQ score was 36. The average immediate post-operative MOXFQ score was 25. The average follow-up MOXFQ was 16. The reduction in MOXFQ score with a minimum of 12 months follow up was statistically significant (p<0.0040) Conclusions DMMO is a safe and effective method for the treatment of metatarsalgia with low complication rates. Our study highlights that clinical improvement of patient’s symptoms may take up to 12 months and beyond following surgery. This should be reiterated to patients prior to surgical intervention.