Clinique du Parc, 155 Boulevard de Stalingrad, 69006 Lyon, France.
Centre Hospitalier Universitaire de Rouen, Service Orthopédie et Traumatologie, 37 Boulevard Gambetta, 76000 Rouen, France.
Foot (Edinb). 2021 Jun;47:101801. doi: 10.1016/j.foot.2021.101801. Epub 2021 Apr 8.
Metatarsal osteotomy is a major means of treating mechanical metatarsalgia. Open techniques are widely used, and notably that described by Weil. They have, however, certain drawbacks, and new types of osteotomy have been developed. Percutaneous techniques are presently very much in favor, and Distal Metatarsal Minimally Invasive Osteotomy (DMMO) has emerged as a treatment for metatarsalgia. Although very widely used, it is poorly codified in the literature.
The present study detailed DMMO techniques and their variants (oblique and reverse), with corresponding indications and treatment decision-tree.
Initial findings seem encouraging, with functional results comparable to those of open surgery. Postoperative edema and radiologic bone healing time seem to be longer in DMMO. There is, on the other hand, no difference regarding stiffness.
DMMO is an effective option to treat metatarsalgia, with variants enabling adaptation to foot morphology, but needing confirmation by studies with higher levels of evidence.
跖骨截骨术是治疗机械性跖痛的主要手段。开放式技术被广泛应用，其中 Weil 描述的技术尤其常见。然而，这些技术存在一定的缺陷，因此出现了新型的截骨术。目前，经皮技术非常流行，跖骨远端微创截骨术（DMMO）已成为治疗跖痛的一种方法。尽管 DMMO 被广泛应用，但它在文献中没有得到很好的规范。
本研究详细介绍了 DMMO 技术及其变体（斜向和反向），并附有相应的适应证和治疗决策树。
初步结果令人鼓舞，功能结果与开放式手术相当。DMMO 术后的水肿和影像学上的骨愈合时间似乎更长，但在僵硬程度方面没有差异。
DMMO 是治疗跖痛的有效方法，其变体可以根据足部形态进行调整，但需要更高证据水平的研究来证实。
