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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2000 March;24(1):29-42
Distal metatarsal realignment. A review of operated cases
Pisani P. C., Pusateri A.
The authors review 73 cases undergoing distal realignment of the metatarsal bones using simple resection or reimplantation of the metatarsal heads, or an association of the two methods. The indications for surgery are described in the introduction. They basically take the form of severe metatarsalgia resulting from deformities of the forefoot and the pathologies responsible: rheumatoid arthritis and other inflammatory infections, degenerative pathology of MF and, not least, the sequelae of previous foot surgery. The preferred access is plantar which gives a broad vision, without problems of vascular insufficiency or cicatrisation. On the contrary, healing is rapid and hardly visible. In terms of the correction of deformities, the disappearance or improvement of painful symptoms, improved gait, the diminution or disappearance of painful hyperkeratosis and the possibility of wearing normal shoes, the results were very satisfactory. The authors evaluated the results mainly on the basis of the patient's subjective opinion. In general/patients regarded the resolution or diminution of pain as being much more important than the cosmetic results. Lastly, the authors point out that the results in patients undergoing reimplantation of the metatarsal heads did not differ from those in whom realignment was performed using simple resection, in terms of both the resolution of pain and the correction of deformities. Moreover, in the case of simple resection, the shorter functional recovery time was an important and constant factor.