Reddy Veerabhadra Babu
Department of Surgery, Texas A&M Health Science Center College of Medicine, Bryan, TX, USA; Foot and Ankle Surgery Fellowship Program, Baylor University Medical Center, Dallas, 3900 Junius Street, Suite 500, Dallas, TX 75246, USA.
Foot Ankle Clin. 2018 Mar;23(1):47-55. doi: 10.1016/j.fcl.2017.10.001. Epub 2017 Nov 20.
Metatarsal osteotomies can be divided into proximal and distal. The proximal osteotomies, such as the oblique, segmental, set cut, and Barouk-Rippstein-Toullec (BRT) osteotomy, all provide the ability to significantly change the position of the metatarsal head without violating the joint. These osteotomies, however, have a high rate of nonunion when done without internal fixation and can lead to transfer metatarsalgia when done without regard to the parabola of metatarsal head position. Distal osteotomies such as the Weil and Helal offer superior healing but have an increased incidence of recurrent metatarsalgia, joint stiffness, and floating toe.
跖骨截骨术可分为近端和远端截骨术。近端截骨术，如斜形、节段性、设定截骨和巴鲁克 - 里普斯坦 - 图勒克（BRT）截骨术，都能够在不侵犯关节的情况下显著改变跖骨头的位置。然而，这些截骨术在不进行内固定时不愈合率较高，并且在不考虑跖骨头位置抛物线的情况下进行时可能导致转移性跖骨痛。远端截骨术，如韦尔截骨术和希拉尔截骨术，愈合效果较好，但复发性跖骨痛、关节僵硬和浮趾的发生率增加。
