The treatment of metatarsalgia by minimally invasive surgery: A cross-sectional study

Introduction: Minimally invasive surgery (MIS) is one of the most innovative approaches for the treatment of metatarsalgia. This cross-sectional study aims to analyse the clinical and radiological outcomes of patients treated for metatarsalgia by this technique and to evaluate their results in relation to the Maestro formula. Methods: Patients between 18 and 80 years, affected by metatarsalgia and treated by percutaneous oblique osteotomies, were included in this study. All patients were assessed radiographically and clinically with internationally validated scales: SF-36, AOFAS, 17-FFI, MOXFQ and VAS. Both outcomes were evaluated in relation to the restoration of the Maestro formula. Statistical analysis was performed and its significance was set at p < 0.05. Results: A total of 91 patients (mean age 51.6 years, M:F = 13:78) with a mean follow-up of 3.9 years (range 2 to 7 years) were evaluated. MIS bone osteotomies were completely healed at a mean time of 3.3 months. We observed significant functional improvement after surgery of all parameters considered in our analysis: AOFAS (84.1 vs. 48.6); 17-FFI (43.2 vs. 7.8); MOXFQ-Pain (11.4 vs. 2.1); MOXFQ-Walking (15.7 vs. 3.9) and MOXFQ-Social (4.8 vs. 0.8). However, the Maestro formula did not improve significantly at last follow-up. Complications occurred in 17 cases and 3 patients required a second operation. Mean VAS satisfaction was 7.785 at last follow-up. Conclusions: MIS has significantly improved the clinical-functional outcomes of patients with metatarsalgia, even if the Maestro formula did not improve significantly.\