Medium-Long-Term Clinical and Radiographic Outcomes of Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy (DMMO) for Central Primary Metatarsalgia: Do Maestro Criteria Have a Predictive Value in the Preoperative Planning for This Percutaneous Technique?

Figure 4

DMMO intraoperative images (2nd): in this position, the DMMO was performed with an angle of approximately 45° with respect to the long axis of the MB in a dorsal-distal to proximal-plantar direction, with rotary motion, extending to the contralateral cortex (A). To verify the completion of the osteotomy of each MB operated on, manual traction on the corresponding toe was applied under fluoroscopic control (B). Before closing the wounds by resorbable sutures (C), the MBs were manually compacted, applying pressure in the distal-proximal direction, pushing their heads dorsally. Finally, after bandage application, a final radiographic check was made to evaluate the correction obtained (D).