Roven M D
Clin Podiatry. 1985 Jul;2(3):491-6.
A previously unreported method to relieve excessive plantargrade pressure which may create an intractable plantar keratoma associated with metatarsal head pain is presented. This method is referred to as an intramedullary metatarsal decompression with condylectomy and is performed through a dorsal minimum incision. The rotary action of the bur is demonstrated. This method has proved less traumatic than previous procedures, permitting immediate ambulation with little postoperative pain or edema. In a series of cases, I have compared this method with control studies on the same patient in which intramedullary metatarsal decompression was performed on one foot and a neck osteotomy on the opposite foot. Results with intramedullary metatarsal decompression have been comparable but have fewer postoperative sequelae. Exuberant bone callus formation dorsally and at the osteotomy site, lateral displacement of bone segments, frequency of transfer lesions, delayed healing or nonunion of the osteotomy site, and the possibility of synostosis when two adjacent bones were osteotomized are all decreased. A short review of the rationale, selection of cases, and criteria for orthotics is presented. The concept and simplified method of treatment applied in a series of cases is described.
本文介绍了一种此前未报道过的缓解过度跖屈压力的方法，这种压力可能会导致与跖骨头疼痛相关的顽固性跖部角化病。该方法称为髁突切除术联合髓内跖骨减压术，通过背侧小切口进行。展示了钻头的旋转动作。事实证明，这种方法比以前的手术创伤更小，术后即可立即行走，疼痛和水肿也很少。在一系列病例中，我将这种方法与对同一患者进行的对照研究进行了比较，其中一只脚进行髓内跖骨减压，另一只脚进行颈部截骨术。髓内跖骨减压的结果相当，但术后后遗症较少。背侧和截骨部位的骨痂过度形成、骨段的侧向移位、转移病变的发生率、截骨部位的延迟愈合或不愈合，以及相邻两块骨头截骨时发生骨融合的可能性均有所降低。本文简要回顾了该方法的原理、病例选择和矫形器标准。描述了在一系列病例中应用的治疗概念和简化方法。
