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Sliding Distal Metatarsal Minimally Invasive Osteotomy (S-DMMO) for the Treatment of Tailor’s Bunion

del Vecchio, Jorge J., MD*; Ghioldi, Mauricio E., MD*; Dalmau-Pastor, Miki, PhD, PT, DPM†,‡; Uzair, Anuar E., MD*; Chemes, Lucas, MD*

Techniques in Foot & Ankle Surgery: March 2019 - Volume 18 - Issue 1 - p 37–42
doi: 10.1097/BTF.0000000000000195
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Bunionette, or Tailor’s bunion, refers to a painful lateral prominence at the fifth metatarsal head. Metatarsal osteotomies have proved to be a successful treatment, and have been described at the distal, diaphyseal, and proximal levels. Distal metatarsal osteotomies have been reported as effective in bunionette correction in several clinical studies. In the last decade, there has been a growing interest in the use of percutaneous or minimally invasive surgery for the treatment of this condition. Minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) has proved to be successful when treating metatarsalgia. We present a surgical technique consisting in a distal osteotomy of the fifth metatarsal, which resembles DMMO, but requires a lateral displacement. We retrospectively investigated 38 feet from 32 patients with symptomatic bunionette deformity and showed good to excellent functional and clinical results. The S-DMMO proved to be a safe (low complication rate) and effective (adequate clinical results and powerful radiologic correction) procedure for the treatment of bunionette deformity.

Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.

*Foot and Ankle Section, Orthopaedics Department, Favaloro Foundation—University Hospital, Buenos Aires, Argentine

Human Anatomy and Embriology Unit, Experimental Pathology and Therapeutics Department, University of Barcelona, Barcelona

Faculty of Health Sciences at Manresa, University of Vic—Central University of Catalonia, Manresa, Spain

The authors declare no conflict of interest.

Address correspondence and reprint requests to Jorge J. del Vecchio, MD, 461 Solis St., 1st Floor, Ciudad Autónoma de Buenos Aires (CABA), Argentine, CP 1078. E-mail: javierdv@mac.com.

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