A Retrospective Review of the Weil Metatarsal Osteotomy for Lesser Metatarsal Deformities: An Intermediate Follow-up Analysis

The purpose of this retrospective clinical study was to determine the clinical results of the Weil metatarsal osteotomy. There were 51 patients (89 procedures), consisting of 10 males and 41 females, with a mean 53.1 ± 11.9 years. Patients were evaluated for subjective improvement on a scale from 0 to 10, and asked if they would repeat the procedure. They were evaluated functionally using the American Orthopedic Foot and Ankle Society's lesser metatarsal rating scale, and assessed for toe purchase and range of motion. Thirty-nine point two percent of patients reported a complete resolution of pain (10/10 points), with 13.7% reporting a score of ≤ 5/10. Eighty percent of the patients would repeat the procedure. The most common complication was toe elevation in 33% of patients. Joint range of motion was reduced in most cases. Thirty five patients experienced no pain at end range of motion, 6 related significant pain and 9 patients experienced some pain. Patients who underwent the procedure as a prophylactic measure along with a first ray procedure formed a significant subgroup (31%). These patients also scored well in comparison to the remainder of patients, with a mean subjective score of 8.4/10 as compared with 7.9/10 for the remainder of patients. The prophylactic group also demonstrated a median functional rating scale score of 90, versus 80 for the remainder of patients. These findings suggest that the Weil metatarsal osteotomy is a useful procedure for metatarsalgia and may also be useful in preventing lesser metatarsalgia in conjunction with first metatarsal surgery.