Ultrasound-guided distal minimally invasive metatarsal osteotomies (US-DMMO): A cadaveric study about its safety and accuracy

• Published in: Foot and ankle surgery Vol. 28; no. 4; pp. 445 - 449
• Main Authors: Martínez-Ayora, Alvaro, Cuervas-Mons, Manuel, Fajardo-Ruiz, Ana, Rodríguez-López, Tamara, Vaquero, Javier, Sanz-Ferrando, Luis
• Format: Journal Article
• Language: English
• Published: France Elsevier Ltd 01.06.2022
• Subjects: Cadaver; Cadaveric; DMMO; Humans; Metatarsal Bones - diagnostic imaging; Metatarsal Bones - surgery; Metatarsalgia; Metatarsalgia - surgery; Minimally Invasive Surgical Procedures - methods; Osteotomy - methods; Percutaneous; Ultrasonography, Interventional; Ultrasound; Percutaneous; DMMO; Metatarsalgia; Cadaveric; Ultrasound
• ISSN: 1268-7731; 1460-9584
• DOI: 10.1016/j.fas.2021.08.005

•Ultrasound is an alternative method to conventional radiology for distal metatarsal minimal invasive osteotomies.•Ultrasound-guided DMMO is safe and accurate.•The dorsal hump is a constant, extra-articular, safe, and valid osteotomy point. Distal minimally invasive metatarsal osteotomies have become increasingly popular. This technique requires fluoroscopic control, but recently, an ultrasound-guided procedure has been described. The aim of this anatomical study was to assess the quality safety of ultrasound-guided minimally invasive metatarsal osteotomies. Ultrasound-guided distal minimally invasive metatarsal osteotomies were performed in 9 cadaveric pieces. The location of the osteotomy, its angulation, and the adjacent anatomical structures injuries was evaluated Thirty-six osteotomies were performed. The osteotomy was metaphyseal in 97.2% of the cases, the average angulation was 47.67° (±4.49, 40−59°) and the average distance to the articular cartilage was 3.22 mm (±1.27, 1−7 mm). One osteotomy (2.8%) was intraarticular and there was one joint capsule lesion (2.8%). The failure, the extreme point distance and angulation values, and the joint capsule injury correspond to a fifth metatarsal. The ultrasound-guided technique is safe and allows a correct location and angulation of the osteotomies.