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

Beech, Ian; Rees, S.; Tagoe, Mark

doi:10.1053/j.jfas.2005.07.002

Cited by 61 publications

(40 citation statements)

References 19 publications

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“…20 The test also has been shown to be a useful indicator of the ability to plantarflex the toes after lesser metatarsal surgery. 4 This study has a number of limitations. First, the method of evaluating toe plantarflexion strength required that the examiner stabilize the ankle to prevent participants from elevating their heels and activating their ankle plantarflexor muscles.…”

Section: Discussionmentioning

confidence: 94%

Plantarflexion Strength of the Toes: Age and Gender Differences and Evaluation of a Clinical Screening Test

Menz¹,

Zammit²,

Munteanu³

et al. 2006

Foot Ankle Int.

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Section: Discussionmentioning

confidence: 94%

Plantarflexion Strength of the Toes: Age and Gender Differences and Evaluation of a Clinical Screening Test

Menz¹,

Zammit²,

Munteanu³

et al. 2006

Foot Ankle Int.

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“…Numerous surgical treatments are used, each with its benefits and complications . Surgical treatment redistributes pressure under the metatarsal heads by either dorsally displacing the head or by shortening the length of the metatarsal . The amount of shortening is determined by the surgeon's experience considering the preoperative length of the metatarsals …”

mentioning

confidence: 99%

“…The detached metatarsal head is moved proximally and reattached. The DP osteotomy is often successful at reducing forefoot pain, but complications occur . An improper osteotomy plane can shift the MTPJ center of rotation, causing the interosseous muscles to act as dorsiflexors causing dorsiflexion contracture .…”

mentioning

confidence: 99%

Second metatarsal osteotomies for metatarsalgia: A robotic cadaveric study of the effect of osteotomy plane and metatarsal shortening on plantar pressure

et al. 2013

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Symptom relief of recalcitrant metatarsalgia can be achieved through surgical shortening of the affected metatarsal, thus decreasing plantar pressure. Theoretically an oblique metatarsal osteotomy can be oriented distal to proximal (DP) or proximal to distal (PD). We characterized the relationship between the amount of second metatarsal shortening, osteotomy plane, and plantar pressure. We hypothesized that the PD osteotomy is more effective in reducing metatarsal peak pressure and pressure time integral. We performed eight DP and eight PD second metatarsal osteotomies on eight pairs of cadaveric feet. A custom designed robotic gait simulator (RGS) generated dynamic in vitro simulations of gait. Second metatarsals were incrementally shortened, with three trials for each length. We calculated regression lines for peak pressure and pressure time integral vs. metatarsal shortening. Shortening the second metatarsal using either osteotomy significantly affected the metatarsal peak pressure and pressure time integral (first and third metatarsal increased, p < 0.01 and <0.05; second metatarsal decreased, p < 0.01). Changes in peak pressure (p ¼ 0.0019) and pressure time integral (p ¼ 0.0046) were more sensitive to second metatarsal shortening with the PD osteotomy than the DP osteotomy. The PD osteotomy plane reduces plantar pressure more effectively than the DP osteotomy plane. Keywords: second metatarsal; plantar pressure; metatarsalgia; lesser metatarsal osteotomies; gait simulation Metatarsalgia is defined as pain, often during weight bearing, of the plantar aspect of the foot under and related to the lesser metatarsal heads. Primary metatarsalgia is associated with biomechanical insufficiencies, and secondary metatarsalgia is associated with systemic conditions. 1 Initially, metatarsalgia is managed with rest, stretching exercises, cushioning, plantar callosity shaving, and anti-inflammatory medications, but data confirming their effectiveness is limited.2 If symptoms persist, surgery is employed to correct the alignment of the metatarsals and/or muscle/ligament balance. Numerous surgical treatments are used, each with its benefits and complications.2-6 Surgical treatment redistributes pressure under the metatarsal heads 7 by either dorsally displacing the head or by shortening the length of the metatarsal. 3 The amount of shortening is determined by the surgeon's experience considering the preoperative length of the metatarsals. 4,8 In this study, we compared the effects of two different osteotomy planes and the overall amount of second metatarsal shortening on plantar pressure. Insight into the relationship between osteotomy plane, metatarsal shortening, and plantar pressure contributes to a more effective treatment of metatarsalgia by providing the surgeon with greater knowledge of biomechanical principles that can be used to make intraoperative osteotomy decisions.The oblique distal to proximal (DP) sliding osteotomy and the oblique proximal to distal (PD) sliding osteotomy are designed to reduce sec...

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“…Patient satisfaction with this procedure has been reported to range between 47% and 88% of cases, 115,117-120 with complete resolution of the lesion reported in 39-78% of cases. 115,118,[120][121][122] The most commonly reported complication associated with the procedure is fl oating toes (15-36% of cases), 117,118,120,122 although transfer lesions are also relatively common (5-20% of cases). 117,118,121,122 Although few direct comparisons of success rates according to age have been undertaken, Winson et al 115 have observed that complications are more likely in people aged over 65 years.…”

Section: Orthopaedic Surgerymentioning

confidence: 99%

Keratotic disorders

Menz

2004

Foot Problems in Older People

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

Cited by 61 publications

References 19 publications

Plantarflexion Strength of the Toes: Age and Gender Differences and Evaluation of a Clinical Screening Test

Plantarflexion Strength of the Toes: Age and Gender Differences and Evaluation of a Clinical Screening Test

Second metatarsal osteotomies for metatarsalgia: A robotic cadaveric study of the effect of osteotomy plane and metatarsal shortening on plantar pressure

Keratotic disorders

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