Maestro Formula: How to perform

Last updated on July 6 2022

Description

To solve the primary metatarsalgia the metatarsal shortening osteotomy should be used. The disorder of the metatarsals’ lengths should be correct with the Maestro formula where:  

• the first metatarsal (M1) length is the same as the second (M2): index plus/minus, ideally first metatarsal length shorter than second 1 - 3 mm;
• the third metatarsal (M3) is 3 mm shorter than the second;
• the fourth metatarsal (M4) is 6 mm shorter than the third;
• the fifth metatarsal (M5) is 12 mm shorter than the fourth;
• the lateral sesamoid center should be aligned with the M4 head center.

Measurements

The measurements made by the procedure are displayed in the image:

• M2: the distance between a parallel line to the sesamoid line that passes through the M1 tip and a parallel line that passes through the M2 tip;
• M3: the distance between a parallel line to the sesamoid line that passes through the M2 tip and a parallel line that passes through the M3 tip;
• M4: the distance between a parallel line to the sesamoid line that passes through the M3 tip and a parallel line that passes through the M4 tip;
• M5: the distance between a parallel line to the sesamoid line that passes through the M4 tip and a parallel line that passes through the M5 tip.

Auxiliary References

To show this procedure, PeekMed® needs additional references:

• Sagittal foot axis: axis starting in the midpoint between the most medial point of the talonavicular joint and the most lateral point of the calcaneocuboid joint and ending on the M2 tip;
• Sesamoid line: perpendicular line to the sagittal axis from the center of the lateral sesamoid of the M1.