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Lesser-Metatarsal Medial Displacement Osteotomy for the Treatment of Digital Transverse Plane Deformities

W. Preston Goforth, DPM ^* , Troy D. Overbeek, DPM ^*, Richard D. Odom, DPM ^*, Tommy G. Roe, DPM ^* and Douglas K. McDonald, MD ^*

^* Department of Surgery, Division of Podiatry, Scott & White Memorial Hospital and Clinic and Scott, Sherwood and Brindley Foundation, Texas A&M University System Health Science Center, College of Medicine, Temple. Dr. Goforth is now deceased. Dr. Overbeek is now at Trinity Mother Frances Health System, Tyler, TX.
Department of Podiatry, University of Texas Health Science Center, San Antonio.

Corresponding author: Troy D. Overbeek, DPM, Trinity Mother Frances Health System, 1034 Clinic Dr, Tyler, TX 75701.

Abstract

We sought to evaluate the clinical and radiographic outcomes in patients treated with a medial displacement transverse osteotomy of the second metatarsal to correct transverse hammer toe deformities. Eighteen patients underwent 20 procedures in 3 years. Each patient had a transverse plane deformity of the second metatarsophalangeal joint. Evaluation consisted of clinical examination, radiographic examination, and self-reported pain and function parameters. Mean ± SD follow-up was 2.5 ± 1.0 years. Radiographic joint congruence improved from 20% before surgery to 95% after surgery. Clinical examination revealed a rectus digit in 85% of cases, a transverse plane deviation in 10%, and a residual hammer toe deformity in 5%. At follow-up, the mean ± SD visual analog scale score for pain with activity was 2.2 ± 2.8 and for pain at rest was 0.6 ± 1.4. Ninety-five percent of the patients said that they would undergo the procedure again. Medial displacement osteotomy for transverse plane deformity of the second metatarsophalangeal joint is a reliable procedure, with substantial improvement in joint congruence and self-reported pain. (J Am Podiatr Med Assoc 95(6): 550–555, 2005)