IVAN CARVALHO GIAROLA

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FMUSP, Hospital das Clínicas, Faculdade de Medicina - Médico

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Autor: AUCH, Elijah ×

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  • article 1 Citação(ões) na Scopus
    Risks of injury in distal metatarsal minimally invasive osteotomy when comparing standard and modified techniques: A cadaveric study
    (2022) AUCH, Elijah; MANSUR, Nacime Salomao Barbachan; LALEVEE, Matthieu; MALY, Connor; MARTINS, Fernando; GIAROLA, Ivan; LI, Shuyuan; GODOY-SANTOS, Alexandre Leme; NETTO, Cesar de Cesar
    Background: The objectives of the study were to evaluate the structures at risk in distal metatarsal mini -invasive osteotomy (DMMO) and to compare standard and intraosseous approaches. Methods: DMMO was performed on the second and fourth metatarsals of 11 fresh-frozen cadaveric spe-cimens. The standard technique was performed in 11 metatarsals. It was then compared to a modified intraosseous technique that entails starting inside the bone in 11 other metatarsals. The cadavers were dissected to identify unintentional injury to soft tissue structures. Results: In the standard group the most injured structures were the metatarsal joint capsules (MJC) (27%), extensor digitorum longus (EDL) (18%), and extensor digitorum brevis (EDB) (9%). The modified intraosseous group injured the EDL (27%), not the MJC (0%) and the EDB (0%). Distances between osteotomies and the dorsal metatarsal head articular surface (DMHAS) were 6.08 +/- 3.99 mm in the standard and 9.92 +/- 3.42 mm in the modified (p = 0.02). Conclusion: The DMMO techniques most frequently injured the EDL. Intra-articular positioning of the os-teotomy was more observed in the standard. Overall, it appears the modified method could be an alter-native to the standard DMMO. Clinical relevance: The modified minimally invasive DMMO has a comparable rate of potential iatrogenic in-juries. This intraosseous procedure may present as an option when planning surgery to the lesser metatarsals. Level of Evidence: Level III. Comparative Cadaveric Study.