Clinical effectiveness and safety of Weil's osteotomy and distal metatarsal mini-invasive osteotomy (DMMO) in the treatment of metatarsalgia: A systematic review

Amado Rivero-Santana; Lilisbeth Perestelo-Pérez; Gerardo Garcés; Yolanda Álvarez-Pérez; Antonio Escobar; Pedro Serrano-Aguilar

doi:10.1016/j.fas.2018.06.004

Clinical effectiveness and safety of Weil's osteotomy and distal metatarsal mini-invasive osteotomy (DMMO) in the treatment of metatarsalgia: A systematic review

Foot Ankle Surg. 2019 Oct;25(5):565-570. doi: 10.1016/j.fas.2018.06.004. Epub 2018 Jul 5.

Authors

Amado Rivero-Santana¹, Lilisbeth Perestelo-Pérez², Gerardo Garcés³, Yolanda Álvarez-Pérez⁴, Antonio Escobar⁵, Pedro Serrano-Aguilar⁶

Affiliations

¹ Canary Islands Foundation of Health Research, Bco. de la Ballena, s/n, 35019 Las Palmas de GC, Spain; Health Services Research on Chronic Patients Network, Camino Candelaria, 44, El Rosario, 38109 Tenerife, Spain; Center for Biomedical Research of the Canary Islands, Campus Ciencias de La Salud, s/n, 38071 San Cristobal de La Laguna, Spain. Electronic address: amado.riverosantana@sescs.es.
² Health Services Research on Chronic Patients Network, Camino Candelaria, 44, El Rosario, 38109 Tenerife, Spain; Center for Biomedical Research of the Canary Islands, Campus Ciencias de La Salud, s/n, 38071 San Cristobal de La Laguna, Spain; Evaluation Unit of the Canary Islands Health Service, Camino Candelaria, 44, El Rosario, 38109 Tenerife, Spain. Electronic address: lilisbeth.peresteloperez@sescs.es.
³ Department of Orthopedics, Hospital Perpetuo Socorro, C/León y Castillo, 407, 35007 Las Palmas de Gran Canaria, Spain; School of Medicine, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n, 35016 Las Palmas de Gran Canaria, Spain. Electronic address: ggarces@imqc.es.
⁴ Canary Islands Foundation of Health Research, Bco. de la Ballena, s/n, 35019 Las Palmas de GC, Spain; Health Services Research on Chronic Patients Network, Camino Candelaria, 44, El Rosario, 38109 Tenerife, Spain; Center for Biomedical Research of the Canary Islands, Campus Ciencias de La Salud, s/n, 38071 San Cristobal de La Laguna, Spain. Electronic address: yolanda.alvarezperez@sescs.es.
⁵ Health Services Research on Chronic Patients Network, Camino Candelaria, 44, El Rosario, 38109 Tenerife, Spain; Research Unit, Hospital Basurto, Montevideo Etorb., 18, 48013 Bilbao, Spain. Electronic address: ANTONIO.ESCOBARMARTINEZ@osakidetza.eus.
⁶ Health Services Research on Chronic Patients Network, Camino Candelaria, 44, El Rosario, 38109 Tenerife, Spain; Center for Biomedical Research of the Canary Islands, Campus Ciencias de La Salud, s/n, 38071 San Cristobal de La Laguna, Spain; Evaluation Unit of the Canary Islands Health Service, Camino Candelaria, 44, El Rosario, 38109 Tenerife, Spain. Electronic address: pseragu@gobiernodecanarias.org.

PMID: 30321939
DOI: 10.1016/j.fas.2018.06.004

Abstract

Background: Weil's osteotomy (WO) is the most applied surgical treatment for metatarsalgia, a persistent pain in the lesser metatarsals' heads. We aim to review its effectiveness and safety compared to the percutaneous technique known as distal metatarsal mini-invasive osteotomy (DMMO).

Methods: Systematic review in Medline, Pubmed, Embase, Cinahl and Cochrane Library. We included studies that directly compared WO and DMMO for the treatment of primary metatarsalgia. Data on pain, function, complications and patients' satisfaction were extracted and narratively synthesized.

Results: Four retrospective studies were identified. There were no significant differences in clinical effectiveness or patients' satisfaction. Time to bone healing was significantly longer for DMMO, whereas WO showed more wound problems and metatarsophalangeal stiffness. Other complications were infrequent in the two procedures.

Conclusion: Evidence on the direct comparison of WO and DMMO is scarce and of low quality. Randomized studies are needed in order to control for potential confounders.

Keywords: DMMO; Distal metatarsal mini-invasive osteotomy; Metatarsalgia; Weil’s osteotomy.

Publication types

Systematic Review

MeSH terms

Arthrodesis / methods*
Humans
Metatarsal Bones / surgery*
Metatarsalgia / surgery*
Metatarsophalangeal Joint / surgery*
Minimally Invasive Surgical Procedures / methods*
Osteotomy / methods*
Patient Satisfaction
Plastic Surgery Procedures / methods*
Treatment Outcome