{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:44:07Z","timestamp":1789656247746,"version":"4.0.1"},"reference-count":24,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T00:00:00Z","timestamp":1545177600000},"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 &amp; Ankle Specialist"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Diabetic foot ulcers (DFUs) are usually treated with conservative management based on debridement, topical agents, and nonsurgical off-loading; however, the recurrence rate following such standard care is reported to be high. In the case of recalcitrant or recurrent ulcers, a surgical off-loading technique such as the metatarsal osteotomy (MO) is indicated. Thus, the aim of this study is to conduct a meta-analysis evaluating the efficacy of MO in treating DFUs. Four relevant studies were identified, including 119 patients with 129 DFUs; all wounds were refractory to a previous conservative treatment of a mean duration of 10.9 \u00b1 4.2 months. With a mean follow-up period of 18.2 \u00b1 5.7 months, the weighted pooled rates were as follows: 98.7% for ulcer healing (in a mean time to heal of 6.5 \u00b1 1.2 weeks), 4.3% for ulcer recurrence, 10.3% for ulcer transfer, 3.7% for infection, and 3.4% for nonunion. These findings were found to be noticeably better than those reported in the literature following standard care, whether associated or not to nonsurgical off-loading methods and that for all the studied outcomes. Knowing the dismal natural history of recalcitrant DFUs treated conservatively, the results of the MO techniques seems to offer a promising alternative in terms of ulcer healing and ulcer complications. In addition to complicated wounds, the indications for MO could include noncomplicated ulcers with healing delay.<\/jats:p>\n                  <jats:p>Level of Evidence: Level IV<\/jats:p>","DOI":"10.1177\/1938640018819784","type":"journal-article","created":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T06:22:37Z","timestamp":1545200557000},"page":"555-562","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Metatarsal Osteotomies for Treating Neuropathic Diabetic Foot Ulcers: A Meta-analysis"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0094-9892","authenticated-orcid":false,"given":"Kaissar","family":"Yammine","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Lebanese American University Medical Center, Rizk Hospital, Lebanese American University, School of Medicine, Beirut, Lebanon (KY, MN, CA)"},{"name":"Diabetic Foot Clinic, Lebanese American University Medical Center, Rizk Hospital, Beirut, Lebanon (KY)"},{"name":"Center for Evidence-Based Anatomy, Sport and Orthopedics Research (KY, MN, CA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Nahed","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Lebanese American University Medical Center, Rizk Hospital, Lebanese American University, School of Medicine, Beirut, Lebanon (KY, MN, CA)"},{"name":"Diabetic Foot Clinic, Lebanese American University Medical Center, Rizk Hospital, Beirut, Lebanon (KY)"},{"name":"Center for Evidence-Based Anatomy, Sport and Orthopedics Research (KY, MN, CA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chahine","family":"Assi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Lebanese American University Medical Center, Rizk Hospital, Lebanese American University, School of Medicine, Beirut, Lebanon (KY, MN, CA)"},{"name":"Diabetic Foot Clinic, Lebanese American University Medical Center, Rizk Hospital, Beirut, Lebanon (KY)"},{"name":"Center for Evidence-Based Anatomy, Sport and Orthopedics Research (KY, MN, CA)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,12,19]]},"reference":[{"key":"bibr1-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-016-0474-y"},{"key":"bibr2-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.06.003"},{"key":"bibr3-1938640018819784","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0331"},{"key":"bibr4-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054"},{"key":"bibr5-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-018-0248-3"},{"key":"bibr6-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1177\/1534734614555002"},{"key":"bibr7-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1086\/383269"},{"key":"bibr8-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01640.x"},{"key":"bibr9-1938640018819784","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.12.2161"},{"key":"bibr10-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1177\/107110070302400905"},{"key":"bibr11-1938640018819784","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"bibr12-1938640018819784","doi-asserted-by":"crossref","unstructured":"Moola S, Munn Z, Tufanaru C, et al. Systematic reviews of etiology and risk. In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer\u2019s Manual. Adelaide, Australia: Joanna Briggs Institute; 2017. https:\/\/wiki.joannabriggs.org\/display\/MANUAL\/Chapter+7%3A+Systematic+reviews+of+etiology+and+risk. Accessed December 4, 2018.","DOI":"10.46658\/JBIRM-17-06"},{"key":"bibr13-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717735640"},{"key":"bibr14-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1177\/107110079902000203"},{"key":"bibr15-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-016-0414-x"},{"key":"bibr16-1938640018819784","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-80-4-211"},{"key":"bibr17-1938640018819784","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.5.692"},{"key":"bibr18-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2003.06.006"},{"key":"bibr19-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2004.01375.x"},{"key":"bibr20-1938640018819784","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.2.290"},{"key":"bibr21-1938640018819784","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-2043"},{"key":"bibr22-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177176"},{"key":"bibr23-1938640018819784","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.1048"},{"key":"bibr24-1938640018819784","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640018819784","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1938640018819784","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640018819784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:34:02Z","timestamp":1777412042000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1938640018819784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,19]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1177\/1938640018819784"],"URL":"https:\/\/doi.org\/10.1177\/1938640018819784","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,19]]}}}