Restoring The Metatarsal Parabola With The Weil Osteotomy

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Here is a postoperative view of the fixation with the shortened second metatarsal.
Restoring The Metatarsal Parabola With The Weil Osteotomy
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Author(s): 
By Thomas Cusumano, DPM

In Conclusion
The Weil osteotomy is a simple technique you should consider in your arsenal for treating a long metatarsal. You can control the amount of shortening to alleviate the symptoms and adjust it for additional elevation or treatment of a crossover digital deformity. Also be aware that you may have to treat concomitant deformities, such as a hammertoe contracture, hallux valgus and hypermobility, in order to help ensure optimal improvement of the level of function. I find the Weil osteotomy to be a more stable shortening or elevating osteotomy than the ‘V’ osteotomy with results that are more predictable. n

Dr. Cusumano is an Associate of the American College of Foot and Ankle Surgeons.
Dr. Braver (pictured at right) is board certified in foot and ankle surgery by the American Board of Podiatric Surgery. A Fellow of the American College of Foot and Ankle Surgeons, he practices in Englewood, NJ.




References:

References 1. Vandeputte G et al.: The Weil osteotomy of the lesser metatarsals: A clinical and pedoparographic follow-up study. Foot and Ankle International, 21(5); 370-374, 2000. 2. Jiminez AL, Martin DE, and Philips AJ: Lesser metatarsalgia evaluation and treatment. Clin. Podiatric Med. Surg., 7(4); 597-618, 1990. 3. Davies MS and Saxby TS: Metatarsal neck osteotomy with rigid internal fixation for the treatment of lesser toe metatarsalphalangeal joint pathology. Foot & Ankle, 20 (10); pp630-635. 4. Lauf E and Weinraub GM: Asymmetrical osteotomy: A predictable surgical approach for chronic central metatarsalgia. J Foot and Ankle Surgery, 35(6); 550-559, 1996. 5. Schlefman BS: Radiology, ch.1. In Comprehensive Textbook of Foot Surgery, 2nd ed., vol 1, Baltimore, Williams &Wilkins, 1992, pp6-8. 6. McGlamry ED: Lesser Ray Deformities, ch.12. In Comprehensive Textbook of Foot Surgery, 2nd ed., vol 1, Baltimore, Williams &Wilkins, 1992, pp321-387.

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