Second Metatarsal Osteotomy Shortening with Tarsometatarsal Arthrodesis : Comparison of Outcomes Between MSPTM Metatarsal Shortening System and Plates and Screws

Background: Metatarsalgia is a common cause of pain which results from several mechanisms. Care of metatarsalgia includes operative management with metatarsal osteotomy when initial conservative management fails. Multiple osteotomy techniques with varying success have been developed and described, including open reduction and internal fixation and a newer MSP metatarsal shortening system. Methods: A historical group composed of 95 patients compromising 126 osteotomies was compared to a MSP group composed of 42 patients and 60 osteotomies. Patient records were reviewed retrospectively to determine the union rate and complications experienced. Results: 125 of 126 osteotomies in the historical group and 60 of 60 osteotomies in the MSP group were successfully united. Complications included non-union (historical group: 1 patient) and delayed union (MSP group: 3 patients), superficial wound infections (historical group: 2, MSP group: 5), and additional recommended surgical intervention (historical group: 1, MSP group: 2). Conclusions: Although further investigation into clinical markers of progress and role of concomitant procedures needs to be completed, the MSP system resulted in comparable union rate to traditional osteotomy with open reduction and internal fixation.