HELAL METATARSAL OSTEOTOMY FOR THE TREATMENT OF METATARSALGIA - A CRITICAL ANALYSIS OF RESULTS

We reviewed the results of treatment of 114 feet in 96 patients with p ressure metatarsalgia treated with a metatarsal osteotomy performed ac cording to the technique of Helal. Clinical examination was performed according to a standardized evaluation questionnaire using the America n Orthopaedic Foot and Ankle Society Lesser Metatarsophalangeal-Interp halangeal Scale. The results were correlated with number of metatarsal osteotomies, the length of the follow up, the age of the patient, and type of additional procedures performed, Sixty-one percent of the pat ients rated the operation as excellent or good, Patient age and number of osteotomies did not influence the results; however, the length of time following surgery and associated Keller-Brandes resection arthrop lasty influenced the outcome negatively, There was a high incidence of increased transfer of weight to adjacent metatarsals. We concluded th at the Helal type metatarsal osteotomy is unlikely to predictably achi eve symptom relief over a long period.