Foot Clinic Vienna, Vienna, Austria.
Orthopaedic Hospital Speising Vienna, Vienna, Austria.
Foot Ankle Int. 2022 Feb;43(2):153-163. doi: 10.1177/10711007211034849. Epub 2021 Aug 17.
The minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) is a percutaneous operative technique with the aim to relieve the symptoms of metatarsalgia. To our knowledge, no previous research has analyzed both pre- and postoperative pedobarographic data including the changes in plantar pressure.
Thirty patients (31 feet) were operated on with a DMMO and included in a prospective study. Clinical, radiologic, and pedobarographic outcomes were evaluated in comparison with the preoperative parameters. The American Orthopaedic Foot & Ankle Society (AOFAS) forefoot score, the Foot Function Index (FFI), the Foot and Ankle Outcome Score (FAOS), and a visual analog scale (VAS) for pain were used in order to assess clinical parameters. Radiographs were taken to compare metatarsal lengths. The pedobarographic analysis served to determine plantar peak pressure (PPP) beneath the metatarsophalangeal (MTP) joints.
All scores indicated a significant mean pre- to postoperative improvement (AOFAS = 31.9 points, FAOS = 16.3%, FFI = 24.3%, VAS pain = 4.1 points, VAS general limitation = 3.3 points) ( < .05). PPP was substantially reduced in the relevant area (M6 [plantar area beneath the second and third MTP joint] had a mean pre to post PPP = 14.15 N/cm) and concurrently higher in the lateral and medial MTP joint areas (M5 mean pre to post = +14.37, M7 pre to post = +7.11). Our mean metatarsal shortening was 6.6 mm. However, our findings do not demonstrate a significant correlation between metatarsal length relationships and the prevalence of metatarsalgia.
Our results demonstrate a significant improvement in clinical scores and PPP. A statistically significant relation between metatarsal length and the prevalence of metatarsalgia was not found in this prospective case series.
Level IV, case series.
微创跖骨骨干骺端截骨术（DMMO）是一种经皮手术技术，旨在缓解跖痛症的症状。据我们所知，以前没有研究分析过术前和术后的足底压力计数据，包括足底压力的变化。
对 30 例（31 足）患者进行 DMMO 手术，并进行前瞻性研究。与术前参数相比，评估临床、放射学和足底压力计结果。采用美国矫形足踝协会（AOFAS）前足评分、足部功能指数（FFI）、足部和踝关节结局评分（FAOS）以及疼痛视觉模拟评分（VAS）评估临床参数。拍摄 X 线片比较跖骨长度。足底压力计分析用于确定跖趾关节（MTP）下的足底峰值压力（PPP）。
所有评分均表明术前至术后有显著的平均改善（AOFAS=31.9 分，FAOS=16.3%，FFI=24.3%，VAS 疼痛=4.1 分，VAS 一般受限=3.3 分）（<0.05）。相关区域的 PPP 显著降低（M6[第二和第三 MTP 关节下的足底区域]的平均术前至术后 PPP=14.15 N/cm），同时 MTP 关节的外侧和内侧区域的 PPP 升高（M5 术前至术后=+14.37，M7 术前至术后=+7.11）。我们的平均跖骨缩短为 6.6 毫米。然而，我们的发现并没有表明跖骨长度关系与跖痛症的发生率之间存在显著相关性。
我们的结果表明临床评分和 PPP 有显著改善。在这项前瞻性病例系列研究中，未发现跖骨长度与跖痛症发生率之间存在统计学显著关系。
IV 级，病例系列。
