top of page

DMMO and the Floating Toe

Elena Neunteufel, MD, et al. case series, "Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy of the Lesser Toes: Clinical, Radiologic, and Pedobarographic Outcomes," garnered its fair share of likes on various social media channels over the past week. It's also one of the few articles on subject.

Minimally Invasive Distal Metatarsal Metaphyseal Osteotomies (DMMO)? Why? Open lesser metatarsal osteotomies are vexed by cosmesis issues, and dorsiflexion, aka “floating toe,” remains one of the most common challenges. In contrast, purported benefits of DMMO include:

  • a lower cost (on account of no fixation)

  • reduced soft tissue dissection

  • higher patient satisfaction

  • better cosmesis

  • reportedly, fewer complications, including floating toe

But does it ... really?

Overall, the report details the use of the DMMO in 31 feet. Significant improvements in many of the clinical outcome scores, pedobarographic changes and high patient satisfaction are all positive takeaways. Nonetheless, the procedure is not without complications, including considerably shortening and excessive dorsiflexion.

If it ain't broke, don't fix it

Minimally invasive surgery is here to stay, at least for the next decade. However, it will be interesting to see just how many of these techniques are truly adopted by surgeons – especially against mainstay open procedures that provide consistently reproducible outcomes.

Recent Posts

See All

Joint Line Considerations in TAA

by Vince Vacketta, DPM The importance of restoring the native joint line has been well studied in TKA. As surgeons continue to work to improve total ankle arthroplasty (TAA) results, new research focu

MIS Bunions

High on potential, grinding out market share, with research support slowly catching up. Burr-based osteotomy With ever-expanding options in the bunion market, the definition of MIS is a bit elusive. W

AVN & Prosthetic Replacement of the Talus

Avascular necrosis of the talus has been a diagnosis vexing foot-and-ankle surgeons for a long time. Real pain and disability with treatment options have often been lacking. Let's take a deeper look a


FIX Masthead 2000x318 v2.jpg
bottom of page