The DMDO is performed with a 12-mm Shannon Isham burr with an angle of approx- imately 45 with respect to the long axis of the MB in a dorsal-distal to proximal-plantar di- rection (A). Hence, an ideal osteotomy has been performed proximal to the neck with potentially greater elevation of metatarsal head from the ground (B).
This terrific and practical procedure from Biz and Ruggieri is outlined well in this manuscript.
Minimally Invasive Surgery: Osteotomies for Diabetic Foot Disease
KEY POINTS
- The treatment of diabetic foot ulcers is still challenging, but the application of minimally invasive surgery now represents a strategic management of these lesions to achieve health goals, highly uncertain until a few years ago.
- Minimallyinvasivedistalmetatarsaldiaphysealosteotomy(DMDO)isbasedonadistalos- teotomy proximal to the metatarsal neck to reduce the pressure on the ulcer and favor its healing.
- The DMDO technique enables the restoration of the original harmonic distal parabola of the forefoot when possible, or the creation of a new balanced forefoot arch, promoting the healing of chronic pressure ulcers.
- This technique, in association with percutaneous osteotomies and tenotomies of pha- langes, protects diabetic patients with minimal tissue damage, immediate postoperative weight bearing, and reduced risk of potential infections, because it does not require metal fixation.
- In a recent preliminary prospective study, DMDO was proved to be a safe and effective method for promoting the healing of chronic diabetic foot ulcers, regardless of their severity.
Leave a Reply