Minimally invasive distal metaphyseal metatarsal osteotomy (DMMO) for symptomatic forefoot pathology – Short to medium term outcomes from a retrospective case series

The Foot ◽  
2019 ◽  
Vol 38 ◽  
pp. 43-49 ◽  
Author(s):  
Karan Malhotra ◽  
Nikita Joji ◽  
Simon Mordecai ◽  
Ben Rudge
Keyword(s):  
Minimally Invasive ◽  
Case Series ◽  
Metatarsal Osteotomy ◽  
Medium Term ◽  
Retrospective Case ◽  
Retrospective Case Series

scholarly journals Effect of Mini-invasive Floating Metatarsal Osteotomy on Plantar Pressure in Patients With Diabetic Plantar Metatarsal Head Ulcers

2020 ◽  
pp. 107110072097609
Author(s):  
Eran Tamir ◽  
Michael Tamar ◽  
Moshe Ayalon ◽  
Shlomit Koren ◽  
Noam Shohat ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Plantar Pressure ◽  
Case Series ◽  
Metatarsal Head ◽  
Metatarsal Osteotomy ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Retrospective Case Series ◽  
Pressure Time ◽  
Peak Plantar Pressure

Background: Distal metatarsal osteotomy has been used to alleviate plantar pressure caused by anatomic deformities. This study’s purpose was to examine the effect of minimally invasive floating metatarsal osteotomy on plantar pressure in patients with diabetic metatarsal head ulcers. Methods: We performed a retrospective case series of prospectively collected data on 32 patients with diabetes complicated by plantar metatarsal head ulcers without ischemia. Peak plantar pressure and pressure time integrals were examined using the Tekscan MatScan prior to surgery and 6 months following minimally invasive floating metatarsal osteotomy. Patients were followed for complications for at least 1 year. Results: Peak plantar pressure at the level of the osteotomized metatarsal head decreased from 338.1 to 225.4 kPa ( P < .0001). The pressure time integral decreased from 82.4 to 65.0 kPa·s ( P < .0001). All ulcers healed within a mean of 3.7 ± 4.2 weeks. There was 1 recurrence (under a hypertrophic callus of the osteotomy) during a median follow-up of 18.3 months (range, 12.2-27). Following surgery, adjacent sites showed increased plantar pressure and 4 patients developed transfer lesions (under an adjacent metatarsal head); all were managed successfully. There was 1 serious adverse event related to surgery (operative site infection) that resolved with antibiotics. Conclusion: This study showed that the minimally invasive floating metatarsal osteotomy successfully reduced local plantar pressure and that the method was safe and effective, both in treatment and prevention of recurrence. Level of Evidence: Level III, retrospective case series of prospectively collected data.

Non-inferiority of minimally invasive oesophagectomy: an 8-year retrospective case series

2017 ◽  
Vol 31 (9) ◽  
pp. 3681-3689 ◽  
Author(s):  
L. Findlay ◽  
C. Yao ◽  
D. H. Bennett ◽  
R. Byrom ◽  
N. Davies
Keyword(s):  
Minimally Invasive ◽  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Minimally Invasive Oesophagectomy

scholarly journals Distal Chevron Osteotomy Increases Anatomic Intermetatarsal Angle in Hallux Valgus

2020 ◽  
Vol 5 (4) ◽  
pp. 247301142096071
Author(s):  
Jeremy Y. Chan ◽  
Naudereh Noori ◽  
Stephanie Chen ◽  
Glenn B. Pfeffer ◽  
Timothy P. Charlton ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Case Series ◽  
Metatarsal Osteotomy ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Intermetatarsal Angle ◽  
First Metatarsal ◽  
Retrospective Case Series ◽  
Chevron Osteotomy ◽  
Anatomic Axis

Background: Distal chevron metatarsal osteotomy (DCO) is a common technique to address hallux valgus (HV), which involves coronal translation of the capital fragment resulting in a nonanatomic first metatarsal. The purpose of this study was to evaluate the radiographic effect of the DCO on the anatomic vs the mechanical axis of the first metatarsal. Our hypothesis was that patients undergoing DCO would have improvement in the mechanical metatarsal axis but worsening of the anatomic axis. Methods: This was a retrospective case series of consecutive patients who underwent DCO for HV. The primary outcomes were the change in anatomic first–second intermetatarsal angle (a1-2IMA) vs mechanical first–second intermetatarsal angle (m1-2IMA). Secondary outcomes included the change in hallux valgus angle (HVA) and medial sesamoid position. Results: 40 feet were analyzed with a mean follow-up of 21.2 weeks. The a1-2IMA increased significantly (mean, 4.1 degrees) whereas the m1-2IMA decreased significantly (mean, 4.6 degrees) following DCO. There was a significant improvement in HVA (mean, 12.5 degrees). Medial sesamoid position was improved in 21 feet (52.5%). Patients with no improvement in sesamoid position were found to have a larger increase in a1-2IMA (mean, 4.7 vs 3.5 degrees, P = .03) and less improvement in m1-2IMA (mean, 3.8 vs 5.2 degrees, P = .02) compared to patients with improvement in sesamoid position. Conclusion: Distal chevron osteotomy for HV was associated with worsening of the anatomic axis of the first metatarsal despite improvements in the mechanical metatarsal axis, HVA, and medial sesamoid position. Greater worsening of the anatomic axis was associated with less improvement of sesamoid position. Our findings may suggest the presence of intermetatarsal instability, which could limit the power of DCO in HV correction for more severe deformities and provide a mechanism for HV recurrence. Level of Evidence: Level IV, retrospective case series.

scholarly journals Minimally Invasive Lateral Corpectomy of the Thoracolumbar Spine: A Case Series of 20 Patients

2020 ◽  
pp. 219256822094529
Author(s):  
Hai Le ◽  
Joshua Barber ◽  
Eileen Phan ◽  
Richard K. Hurley ◽  
Yashar Javidan
Keyword(s):  
Length Of Stay ◽  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Case Series ◽  
Retroperitoneal Approach ◽  
Adjacent Segment ◽  
Retrospective Case ◽  
Spinal Reconstruction ◽  
Retrospective Case Series ◽  
Estimated Blood Loss

Study Design: Retrospective case series. Objective: To report our experience with corpectomy of the thoracolumbar (TL) spine through a minimally invasive lateral retropleural or retroperitoneal approach. Methods: This is a retrospective case series of 20 consecutive patients who underwent minimally invasive TL corpectomy and spinal reconstruction. Electronic medical records were reviewed for demographic, operative, and clinical outcome data. Results: Between 2015 and 2019, 20 consecutive cases of minimally invasive TL corpectomy were performed, comprising 12 men (60%) and 8 women (40%) with a mean age of 54.3 years. Indications for surgery were infection (n = 6, 30%), metastatic disease (n = 2, 10%), fracture (n = 6, 30%), and calcified disc herniation (n = 6, 30%). Partial and complete corpectomy was performed in 5 patients (25%) and 15 patients (75%), respectively. Mean operative time and estimated blood loss was 276.2 minutes and 558.4 mL, respectively. Mean length of stay from admission and surgery were 14.6 and 11.4 days, respectively. Mean length of stay from surgery for elective cases was 4.2 days. Mean follow-up time was 330.4 days. Visual analogue scale score improved from 7.7 to 4.5 ( P < .01). There were a total of 3 postoperative complications in 2 patients, including 1 mortality for urosepsis. One patient had revision spinal surgery for adjacent segment disease. Conclusions: Corpectomy and reconstruction of the TL spine is feasible and safe using a minimally invasive lateral retropleural or retroperitoneal approach. Since this is a relatively new technique, more studies are needed to compare the short- and long-term radiographic and clinical outcomes between minimally invasive versus open corpectomy of the TL spine.

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