12/26/2016    Don Peacock, DPM, MS

RE: MIS Metatarsal Osteotomy Surgery vs. Akin Osteotomy on Elderly Patients (Dieter J Fellner, DPM)

Dr. Fellner you are exactly right. This
procedure has not been subjected to scientific
evaluation. A modification of the Wilson has
been performed MIS and it is in the literature.
This particular modification has not been.

In order for us to truly back up what we are
saying about this procedure, we are going to
need to publish it. I would not go as far as to
calling it a sound-bite because we do have some
case presentations that have been published in
non-peer-reviewed journal articles. However,
from a purely academic standpoint we will need
to back up what we are saying with scientific
data.

I have performed 10 of these procedures. We
have a collective process going on now where we
are planning to retrieve the data and try to
publish our results. Clinically, the results
have been promising so far. More cases and more
studying is required before the procedure
should be considered by physicians outside of
the study group.

Admittedly, it's premature for us to be singing
the praises of this procedure until more is
known about the postoperative course and the
actual results we are getting long term. That
being said there is nothing wrong with showing
what we are trying to accomplish and the good
results we're getting on a case-by-case basis.
The procedure does follow standard of care
practices and this is an osteotomy style that
has plenty of back-up in the literature. This
is merely a mild modification of a known and
well documented procedure.

Check out "Modifications of the Wilson
Bunionectomy, Clinics of Podiatric Medicine and
Surgery - Vol 8, No 1, Jan 1991 page 95. by
Dennis White, DPM. He performed a retrospective
study on 119 patients utilizing MIS modified
Wilson osteotomy. There were no non-unions.
Only 11 patients were fixated. A few patients
experienced transfer metatarsalgia with only
one patient requiring additional surgery.
Eight patients displayed mild dorsiflexion of
the first metatarsal head that did not receive
fixation.

Don Peacock, DPM, MS, Whiteville, NC

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