Comparative characteristics of distal osteotomies of the middle metatsars for hammer toe deformity and central metatarsalgia
https://doi.org/10.51922/1818-426X.2022.4.82
Abstract
Aim of the study. To compare the effectiveness of distal extension-shortening osteotomy (DESO) of the metatarsals and Weil-osteotomy in the surgical treatment of the middle hammer toe deformity and central metatarsalgia. Treatment outcomes were studied in 80 patients (75 women and 5 men) aged 31 to 79 years (median – 57 [52; 64] years) on 90 feet. The patients were divided into 2 groups: the study group – 32 people, where the DESO was used, and the comparison group – 48 people, in which a typical Weil-osteotomy was performed. Long-term results were studied within 6 to 46 months (median – 24 [10; 33] months). During the examination, a variant of hammertoe deformity was determined, radiometric parameters of the forefoot were measured, the Visual Analogue Scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society Lesser Toe Scale (AOFAS–II–V) were used. After surgery in the study group, the median VAS decreased to 1 [0; 1] points (p < 0,001), in the comparison group – up to 2 [0; 3] points (p < 0,001). Median AOFAS–II–V in the study group increased by 2,2 times and reached 93 [90; 95] points (p < 0,001), in the comparison group it increased only to 85 [73; 90] points (p < 0,001). The received data indicate a higher efficiency of DEMO for hammer toe deformity and central metatarsalgia compared to the standard Weil-osteotomy. The DEMO technique provides a pronounced reduction in pain syndrome (by 6 times), creates conditions for easy elimination of hammer toe deformity, improves the functional state of the forefoot by more than 2,2 times (according to AOFAS–II–V) and obtains positive treatment outcomes in 94,4 % of cases.
About the Authors
E. Mikhnovich
Белорусский государственный медицинский университет
Belarus
Belarus
F. Almagarbeh
Белорусский государственный медицинский университет
Belarus
Belarus
P. Gorodetsky
Белорусский государственный медицинский университет
Belarus
Belarus
References
1. Al’magarbeh, F. M. Vidy molotkoobraznoj deformacii pal’cev stopy / F. M. Al’magarbeh, E. R. Mihnovich // Sovremennye tehnologii v medicinskom obrazovanii [Jelektronnyj resurs]: materialy mezhdunarodnoj nauchno-prakticheskoj konferencii, posvjashhennoj 100-letiju Belorus. gos. med. un-ta, Respublika Belarus’, g. Minsk, 1–5 nojabrja 2021 g. / pod red. S. P. Rubnikovicha, V. A. Filonjuka. – Minsk: BGMU, 2021. – S. 89–91. – 1 jelektron. opt. disk (CD-ROM).
2. Bobrov, D. S. Peregruzochnaja metatarzalgija: patogenez, biomehanika i hirurgicheskoe lechenie (analiticheskij obzor literatury) / D. S. Bobrov, L. Ju. Slinjakov, N. V. Rigin // Vestnik RAMN. – 2017. – T. 72, № 1. – S. 53–58.
3. Kardanov, A. A. Hirurgija perednego otdela stopy v shemah i risunkah / A. A. Kardanov. – M.: Izdatel’skij Dom “MEDPRAKTIKA–M”, 2012. – 144 s.
4. Metod distal’noj jekstenzionno-ukorachivajushhej osteotomii srednej pljusnevoj kosti: instrukcija po primeneniju № 074-0622, utv. M-vom zdravoohranenija Resp. Belarus’ 16.06.22 g. / UO “Belorusskij gosudarstvennyj medicinskij universitet”; E. R. Mihnovich, F. M. Al’magarbeh. – Minsk, 2022. – 12 s.
5. Savincev, A. M. Rekonstruktivno-plasticheskaja hirurgija poperechnogo ploskostopija / A. M. Savincev. – SPb.: OOO “Izdatel’stvo FOLIANT”, 2006. – 200 s.
6. Barouk, L. S. The Weil lesser metatarsal osteotomy / L. S. Barouk // Forefoot reconstruction. – 2nd ed. – Paris: Springer Verlag, 2005. – P. 115–138.
7. Espinosa, N. A New Approach for the Treatment of Metatarsalgia: The Triple Weil Osteotomy / N. Espinosa, M. S. Myerson, P. F. De Retana [et al.] // Techniques Foot Ankle Surg. – 2007. – Vol. 6, № 4. – R. 254–263.
8. Highlander, P. Complications of the Weil osteotomy / P. Highlander, E. Von Herbulis, A. Gonzalez [et al.] // Foot Ankle Spec. – 2011. – Vol. 4, № 3. – R. 165–170.
9. Kitaoka, H. B. Clinical rating systems for the ankie– hindfoot, midfoot, hallux, and lesser toes / H. B. Kitaoka, I. J. Alexander, R. S. Adelaar [et al.] // Foot Ankle Int. – 1994. – Vol. 15, № 7. – R. 349–353.
10. Migues, A. Floating–toe deformity as a complication of the Weil osteotomy / A. Migues, G. Slullitel, F. Bilbao [et al.] // Foot Ankle Int. – 2004. – Vol. 25, № 9. – R. 609–613.
Review
For citations:
Mikhnovich E., Almagarbeh F., Gorodetsky P. Comparative characteristics of distal osteotomies of the middle metatsars for hammer toe deformity and central metatarsalgia. Medical Journal. 2022;(4):82-87. (In Russ.) https://doi.org/10.51922/1818-426X.2022.4.82
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