The Weil Osteotomy for Correction of Fixed Claw-Toe Deformity and Metatarsalgia

Aim: The aim of our study is to evaluate the efficacy of the Weil osteotomy to correct fixed claw lesser toe deformity with dorsal subluxation or dislocation of the MTP joint and overloading metatarsalgia. Material: 120 Weil osteotomies in 60 feet of 45 patients have retrospectively been studied with a minimum follow-up of 12 months (mean f.u. 17 months). Thirty-five patients were women and ten men. For the evaluation of the result we used the AOFAS grading scale. Antero-posterior and lateral weight bearing radiographs were taken preoperatively and at the time of follow-up. Forty patients had a correction of hallux valgus deformity although 5 of the lesser toe only. All patients received a PIP fusion for the correction of the claw deformity. Results: The subjective result was at their expectation for 39 patients and beyond their expectation for 5. One patient was dissatisfied. The AOFAS score improved from 45 preoperatively to 89 postoperatively. Thirty-nine patients did not complain of metatrsalgia although for five patients metatarsalgia improved and for 1 remained at preoperative level. Shoe wearing improved in all 42 patients although for 3 this was below their expectations. Conclusion: The Weil osteotomy combined with PIP fusion is capable of correcting stiff claw lesser toe deformities with dorsal subluxation or dislocation of the MTP joint and significantly improve metatarsalgia.