The modified Schwartz procedure in the management of intractable plantar keratoses: a retrospective review

• Published in: Foot (Edinburgh, Scotland) Scotland), 2003, Vol.13 (2), p.108-113
• Main Authors: Finney, S.M., Kilmartin, T.E., Flintham, C.
• Format: Article
• Language: English
• Subjects: Intractable plantar keratoses; Lesser metatarsal surgery; Schwartz osteotomy
• ISSN: 0958-2592; 1532-2963
• DOI: 10.1016/S0958-2592(03)00008-7

Background: The Schwartz double oblique lesser metatarsal osteotomy has been proposed as a means of managing plantar declinated metatarsals and associated pathology. Objective: The purpose of this study was to review the efficacy of a modification of this procedure in the management of intractable plantar keratoses. Methods: Twenty-five patients (27 feet) with an average follow-up time of 22 months were reviewed retrospectively by means of questionnaire, interview and examination. All patients had undergone an isolated modified Schwartz osteotomy of the 3rd or 4th metatarsal plus full thickness lesion excision for the treatment of a painful plantar corn that had not responded to conservative intervention. Results: Complete resolution of the lesion occurred in only 11 patients (41%), however there was a statistically significant reduction in the frequency of chiropody visits post-operatively and a high level of patient satisfaction. Complications included soft tissue infection in four cases, reduced function of toes in five cases and osteotomy instability in one case. Conclusion: The outcomes of this study could be helpful to all those involved in the management of patients with chronic intractable plantar keratoses.