Weil osteotomy in the treatment of central metatarsalgia

Purpose. To assess the results of Weil osteotomy in the treatment and prevention of overload metatarsalgia in the foot’s central metatarsals. Materials and methods. A retrospective examination was performed of the first forty-two consecutive patients who had been subjected to one or more Weil osteotomies for the treatment or prophylaxis of central metatarsalgia. Two subjects refused to be included in the study, which means that only 48 feet were included from 40 subjects who were subjected to 96 osteotomies. All clinical records were studied and the patients were interviewed in order to determine the aesthetic, radiographical and functional results obtained on the basis of the American Orthopedic Foot and Ankle Society (AOFAS)’s lesser metatarsal and interphalangeal bones’ score. Results. 87.5% of results were considered good or excellent from the functional point of view, with 81.3% being considered good or excellent from the aesthetic point of view. The final score as measured by the AOFAS score was 85 ± 12.6 points. Neither infections nor osseointegration delays were noted. One of the patients was reoperated in the immediate post-op because of a fracture and in four cases the osteosynthesis material had to be retrieved. 66.7% of feel presented with a mild metatarsophalangeal mobility defect. In four patients this defect was serious. Conclusions. Weil osteotomy is a safe and appropriate technique to address central metatarsalgia. It has drawbacks that stem from intolerance to the osteosynthesis material and to metatarsophalangeal mobility defects.