Metatarsal osteotomy using a double-threaded compression screw: an adjunct to revision forefoot surgery.

A double-threaded compression screw (Herbert) was used as internal fixation of metatarsal neck osteotomy and nonunion repair in 16 patients (18 feet). Fifteen patients had associated symptomatic conditions of the foot. Twelve patients had one or more previous surgical procedures on the involved foot. Fourteen patients (15 feet) underwent 20 primary or revision lesser metatarsal osteotomies. Four of these patients had undergone previous lesser metatarsal osteotomies and had developed recurrent pain beneath six metatarsals and transfer metatarsalgia in one case. The remaining two patients (three feet), with six nonunions from previous metatarsal osteotomies, had repair with screw fixation and bone grafting. Follow-up for the series averaged 14 months.