RE: Chronic 1st MPJ Pain (Don Peacock, DPM)

From; Scott Hughes, DPM

I assume Dr. Peacock shared his pre- and post-op x-rays to show the success of his MIS technique.  I think most of us would agree that decompressing the 1st MPJ by shortening and plantarflexing the 1st met head is desirable for hallux limitus. However, the osteotomy, besides being inherently unstable and an elevatus waiting to happen, is oriented to create lengthening. Also, the osteotomy creates a plantar shelf directly above the sesamoids.

I am happy to hear the patient is pain-free, but when I look at this case, my thought is 'better lucky than good' rather than MIS is a viable alternative.

Scott Hughes, DPM, Monroe, MI, [email protected]