{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:37:43Z","timestamp":1787506663288,"version":"build-2736575974"},"reference-count":31,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,8,27]],"date-time":"2015-08-27T00:00:00Z","timestamp":1440633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>As in all fields of surgery, advances in orthopaedic surgery develop toward less invasive surgical techniques. The advantages of smaller incisions include minimal soft tissue dissection allowing procedures to be performed as outpatient surgery. There is the assumption that this leads to a quicker recovery time permitting an earlier return to work. As with any new surgical technique, there is an associated learning curve. This study looked into the outcome of minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) performed at a University Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Thirty patients underwent minimally invasive surgery for DMMO. There were 13 males and 17 females with an average age of 60 years. More than one metatarsal osteotomy was done in all cases to facilitate the moulding of the metatarsal head to the correct alignment with full weight bearing. The outcome was measured with the Manchester-Oxford Foot Questionnaire (MOXFQ), patient-reported outcome (PRO), and visual analog scale (VAS) pain score. Minimum follow up was 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At the final review, the average MOXFQ score was an excellent 31. Average improvement in VAS score was 3.5, which ranged from 10 to -7. The VAS was affected by 2 patients whose pain worsened after the operation. There were 4 complications, one each of nonunion, malunion, transfer metatarsalgia, and soft tissue ossification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The 3 most common complications of foot and ankle surgery are infection, wound dehiscence, and skin ulcer or blister. Intra-articular metatarsal osteotomies are commonly associated with stiffness due to scarring and consequently hammertoes. By reducing the soft tissue injury in minimally invasive surgery, these risks can be potentially minimized. Minimally invasive DMMO produced good patient satisfaction, functional improvement, and low complication rates in most cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, retrospective case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100715598601","type":"journal-article","created":{"date-parts":[[2015,8,27]],"date-time":"2015-08-27T22:49:44Z","timestamp":1440715784000},"page":"58-63","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":73,"title":["Outcome of Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy (DMMO) for Lesser Toe Metatarsalgia"],"prefix":"10.1177","volume":"37","author":[{"given":"Syed","family":"Haque","sequence":"first","affiliation":[{"name":"Sheffield Teaching Hospitals, NHS Trust, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Kakwani","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals, NHS Trust, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Chadwick","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals, NHS Trust, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark Bowen","family":"Davies","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals, NHS Trust, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris M.","family":"Blundell","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals, NHS Trust, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,8,27]]},"reference":[{"key":"bibr1-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2013.06.017"},{"key":"bibr2-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2005.07.002"},{"key":"bibr3-1071100715598601","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2008.0142"},{"key":"bibr4-1071100715598601","first-page":"3","volume-title":"Minimally Invasive Surgery of the Foot and Ankle","volume":"2011","author":"De Prado M"},{"key":"bibr5-1071100715598601","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.1139"},{"key":"bibr6-1071100715598601","first-page":"5201","author":"DiDomenico L","year":"2012","journal-title":"Foot Ankle Spec"},{"key":"bibr7-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1054\/cuor.2002.0269"},{"key":"bibr8-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2010.02.001"},{"key":"bibr9-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1177\/1938640014532131"},{"key":"bibr10-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2011.07.003"},{"key":"bibr11-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1177\/1938640011402822"},{"key":"bibr12-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B11.16590"},{"key":"bibr13-1071100715598601","first-page":"163","volume-title":"Minimally Invasive Surgery of the Foot and Ankle","volume":"2011","author":"Laffenetre O"},{"key":"bibr14-1071100715598601","first-page":"139","volume":"67","author":"Jarde O","year":"2001","journal-title":"Acta Orthop\u00e6dica Belgica"},{"key":"bibr15-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1615-y"},{"key":"bibr16-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502600710"},{"key":"bibr17-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1016\/S1607-551X(09)70538-8"},{"key":"bibr18-1071100715598601","first-page":"35","volume":"12","author":"Maceira E","year":"1998","journal-title":"Revista de Medicina y Cirugia del Pie"},{"key":"bibr19-1071100715598601","first-page":"30","volume":"44","author":"Mifsut D","year":"2009","journal-title":"Rev Esp Cir Osteoart"},{"key":"bibr20-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.24.2000147"},{"key":"bibr21-1071100715598601","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1055\/s-2008-1037390","volume":"137","author":"M\u00fchlbauer M","year":"1999","journal-title":"Z Orthop Ihre Grenzgeb"},{"key":"bibr22-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1016\/j.recot.2010.09.005"},{"key":"bibr23-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2014.02.002"},{"key":"bibr24-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1177\/107110078100100405"},{"key":"bibr25-1071100715598601","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2011.11.001"},{"key":"bibr26-1071100715598601","unstructured":"Soft-Tissue Problems Top Foot and Ankle Complications: 2013 Annual Meeting News. February 19-23, 2013. http:\/\/www.aaos.org\/news\/acadnews\/2013\/AAOS8_3_19.asp. Accessed June 15, 2015."},{"key":"bibr27-1071100715598601","unstructured":"Surgical correction of hallux valgus using minimal access techniques; NICE interventional procedures guidance [IPG332]. http:\/\/www.nice.org.uk\/guidance\/IPG332\/chapter\/2-The-procedure. Published February 2010. Accessed June 13, 2014."},{"key":"bibr28-1071100715598601","unstructured":"The Manchester \u2013Oxford foot Questionnaire: ISIS outcome, Patient reported outcome measures from the University of Oxford. http:\/\/www.isisinnovation.com\/outcomes\/orthopaedic\/moxfq.html. 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