Fernández-Vizcaino Carlos, Naranjo-Ruiz Carmen, Fernández-Ehrling Nadia, García-Vicente Sergio, Nieto-García Eduardo, Ferrer-Torregrosa Javier
Podiatry Department, Faculty of Medicine and Health Sciences, Valencia Catholic University "San Vicente Mártir", 46001 Valencia, Spain.
Admission and Clinical Documentation Unit, Sagunto Hospital, Generalitat Valenciana, Universidad Europea, 46001 Valencia, Spain.
J Clin Med. 2024 Apr 10;13(8):2180. doi: 10.3390/jcm13082180.
Metatarsalgia is a common pathology that is initially treated conservatively, but failure to do so requires surgery, such as the minimally invasive distal metatarsal osteotomy (DICMO). In this prospective study of 65 patients with primary metatarsalgia who underwent DICMO, plantar pressures, American Orthopaedic Foot and Ankle Society MetaTarsoPhalangeal-InterPhalangeal scale (AOFAS-MTP-IP) and Visual Analog Scale (VAS) were evaluated pre-operatively and post-operatively and there was a subgroup in which an inclinometer was used to observe the importance of the inclination of the osteotomy. The results show a significant reduction in plantar pressures after DICMO surgery without overloading the adjacent radii, especially in the subgroup with an inclinometer to guide the osteotomy. The AOFAS-MTP-IP scale evidenced a marked improvement in metatarsal function and alignment with scores close to normal. The VAS scale showed a substantial decrease in pain after DICMO osteotomy. DICMO, with an inclinometer for a 45° osteotomy, proved to be a safe and effective procedure for primary metatarsalgia, although further comparative studies are needed to confirm its superiority.
跖痛症是一种常见的病症，最初采用保守治疗，但如果保守治疗失败则需要进行手术，比如微创跖骨远端截骨术（DICMO）。在这项针对65例接受DICMO手术的原发性跖痛症患者的前瞻性研究中，术前和术后评估了足底压力、美国矫形足踝协会跖趾关节-趾间关节评分量表（AOFAS-MTP-IP）和视觉模拟量表（VAS），并且有一个亚组使用倾角仪观察截骨倾斜度的重要性。结果显示，DICMO手术后足底压力显著降低，且未使相邻半径负重过载，尤其是在使用倾角仪指导截骨的亚组中。AOFAS-MTP-IP量表证明跖骨功能和对线有显著改善，评分接近正常。VAS量表显示DICMO截骨术后疼痛大幅减轻。尽管需要进一步的对照研究来证实其优越性，但对于原发性跖痛症，使用倾角仪进行45°截骨的DICMO被证明是一种安全有效的手术方法。
