Percutaneous Distal Osteotomy of the Fifth Metatarsal for Correction of Bunionette

Abstract

The percutaneous procedure described here is a reliable technique to perform a distal transverse osteotomy of the fifth metatarsal to correct a painful varus fifth-toe deformity with prominence of the fifth metatarsal head. The clinical results are comparable with those reported with traditional open techniques, with the advantages of a minimally invasive surgical procedure, substantially shorter operating time, and a reduced risk of complications.

Percutaneous Distal Osteotomy of the Fifth Metatarsal for Correction of Bunionette

“…Distal osteotomies are indicated for type-II and III bunionette deformities according to the Coughlin classification 10,11,26 since these procedures have the ability to correct the fourth and fifth intermetatarsal angle. Among the several procedures described, a minimally invasive 22 or percutaneous 21,24 distal osteotomy of the fifth metatarsal has the potential to reduce complications because of the limited surgical exposure 21,22,[24][25][26]29,30 .…”

Fifth Metatarsal Osteotomies for Treatment of Bunionette Deformity: A Meta-Analysis of Angle Correction and Clinical Condition

“…These results should therefore be interpreted with caution. The MINORS scores ranged from 6 to 12 of a total of 16, which mainly resulted from the retrospective character of the studies and the lack of blinding (24,32). Also, meta-analyses are prone to publication bias.…”

“…Patient age ranged from 12 to 80 years. Thirteen studies (46%) had included other additional forefoot procedures concurrent with bunionette surgery (11,16,20,22,23,(26)(27)(28)32,33,39,41,42). These procedures consisted of correction of hallux valgus, hallux rigidus, hammertoes, cross-over toes, Morton's neuroma, and hyperkeratotic plantar lesions.…”

Minimally Invasive Surgery of the Forefoot: Current Concept Review

“…Distal osteotomy of the fifth metatarsal is indicated in the surgical treatment of bunionette and varus deformity of the fifth toe in patients with a valgus deviation of the fifth metatarsal [18]. There are many different techniques used to correct deformity of the fifth metatarsal, including soft-tissue procedures, metatarsal osteotomies, or prosthetic implants.…”

“…There are many different techniques used to correct deformity of the fifth metatarsal, including soft-tissue procedures, metatarsal osteotomies, or prosthetic implants. Among the several procedures described, a minimally invasive or percutaneous distal osteotomy of the fifth metatarsal has the potential to reduce complications due to limited surgical exposure [15,18]. Surgery is performed with use of ankle block anesthesia.…”