Distal Metatarsal Osteotomies for Chronic Plantar Diabetic Foot Ulcers

KEY POINTS - Currently, distal metatarsal osteotomies (DMOs) represent the successful application of the best principles of minimally invasive surgery, historically used for the treatment of metatarsalgia, in the operative management of chronic plantar diabetic foot ulcers (CPDFUs). - DMOs, performed at a different level of the distal metatarsal bones, reduce the pressure on the CPDFU and promote its healing - These percutaneous osteotomies (DMOs), planned correctly using weight-bearing dorsoplantar radiographs of the diabetic foot, can restore the original harmonic distal parabola of the forefoot and/or create a new balanced forefoot arch, preventing ulcer recurrence - DMOs are completely changing the traditional surgical approach to CPDFUs with osteomyelitis, preserving the infected metatarsal bone as much as possible. - The recent literature has proven DMOs to be a safe and effective method for the operative management of CPDFUs, regardless of their severity.