Minimally Invasive Distal Metatarsal Diaphyseal Osteotomies (DMDO) in the Diabetic Foot

This terrific and practical procedure from Biz and Ruggieri is outlined well in this manuscript.

Minimally Invasive Surgery: Osteotomies for Diabetic Foot Disease


  •   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.

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