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 evaluatedbetween 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 touse 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.
Highlights
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
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
Embora sejam necessários mais estudos, a incisão plantar utilizada para ressecção das cabeças metatarsais dos dedos menores nas deformidades graves do antepé é um procedimento seguro, confiável e eficaz, com alto índice de bons resultados
Summary
Effect of plantar incision for metatarsal head resection arthroplasty of the small toes. RESUMO Objetivo: Avaliar o resultado clínico da artroplastia de ressecção das cabeças metatarsais dos dedos menores através da via de acesso plantar, em pacientes com deformidades graves do antepé. Todos foram submetidos à mesma técnica cirúrgica com artroplastia de ressecção das cabeças metatarsais dos dedos menores por via plantar. Resultados: Na série estudada, todos os 12 pacientes (15 pés) apresentaram melhora do quadro doloroso com resultado estatístico significativo. Onze indivíduos (14 pés) podiam usar todo tipo de calçado e apenas um utilizava calçado sob medida. Conclusão: A artroplastia de ressecção das cabeças metatarsais dos dedos menores utilizando a via de acesso plantar é uma técnica segura, confiável e eficaz no tratamento de pacientes com deformidades graves do antepé.
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