Vascularization of the heads of the three central metatarsals: an anatomical study, its application and considerations with respect to horizontal osteotomies at the neck of the metatarsals

Leemrijse, T.; Valtin, B.; Oberlin, C.

doi:10.1046/j.1460-9584.1998.00088.x

Cited by 7 publications

(2 citation statements)

References 12 publications

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“…This is because there is a constant plantar artery supplying the metatarsal head and the capsule of the MTP joint. 5 It is essential, therefore, to avoid damage to this structure when performing the osteotomy.…”

Section: Discussionmentioning

confidence: 99%

Metatarsal Neck Osteotomy with Rigid Internal Fixation for the Treatment of Lesser Toe Metatarsophalangeal Joint Pathology

Davies

Saxby

1999

Foot Ankle Int.

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Metatarsalgia associated with metatarsophalangeal (MTP) joint instability and/or plantar callosity formation is a difficult problem to treat. During a 15-month period, we performed 50 osteotomies of the metatarsal neck with rigid internal fixation in 47 feet of 42 patients. Three patients were excluded from the study, leaving 47 osteotomies in 44 feet of 39 patients for review. There were 6 men and 33 women, with a mean age of 57 years. In addition to lesser MTP joint pain with or without instability, the majority of patients had first ray pathologic condition, which was also addressed at the time of surgery. All but one of the osteotomies were united radiologically at 6 weeks. The mean shortening was 4.1 mm (range, 2-12 mm), and the mean follow-up was 9 months. There were no cases of malunion, nonunion, or avascular necrosis. At follow-up, 33 patients were asymptomatic. Eight patients (nine feet) had a degree of persisting pain at follow-up (seven mild and two moderate), but the source of this pain was only the metatarsal or MTP joint that was operated on in three cases. In this article, we describe the indications, the technique, and the results of the osteotomy.

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Section: Discussionmentioning

confidence: 99%

Metatarsal Neck Osteotomy with Rigid Internal Fixation for the Treatment of Lesser Toe Metatarsophalangeal Joint Pathology

Davies

Saxby

1999

Foot Ankle Int.

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“…L'ostéotomie sous-capitale horizontale de Weil nous paraît une intervention parfaitement adaptée au traitement des métatarsalgies ; elle est de technique simple et permet de régler la longueur des métatarsiens pour obtenir un clavier métatarsien harmonieux ; elle ne modifie pas la morphologie des métatarsiens comme les ostéotomies diaphysaires ou métaphysaires proximales et évite ainsi les éventuels conflits nerveux dans les espaces intermétatarsiens ; enfin, les travaux anatomiques de Leemrijse et al [4] ont été rassurants quant au risque de nécrose céphalique que l'on aurait pu craindre a priori. Elle ne doit néanmoins pas faire pousser trop loin les indications chirurgicales en cas de métatarsal-gies qui répondent le plus souvent très bien à un traitement orthétique bien conduit, adapté et évolutif.…”

Section: Resultsunclassified

The Weil’s metatarsal osteotomy: about 34 cases at three years follow-up

Dederichs

Lourak

et al. 2010

Med Chir Pied

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Les auteurs rapportent une série de 34 cas d'ostéo-tomies sous-capitales horizontales de Weil suivis pendant une moyenne de trois ans ; l'âge des patients était en moyenne de 56,8 ans, à prédominance féminine. La voie d'abord était unique dorsale oblique en zigzag ; la synthèse était confiée à des vis classiques non sécables ; l'appui était permis à la 48 e heure grâce à un chausson postopératoire ; un traitement anticoagulant était institué de principe et la réédu-cation débutée au 15 e jour. Le score de Kitaoka est passé de 49,4 à 74,2 points. Le périmètre de marche était supérieur à 1 000 m dans 73 % des cas ; la mobilité des orteils atteignait en moyenne 20°en flexion dorsale et 40°en flexion plantaire ; le signe du bristol était positif dans 88 % des cas. L'intervention de Weil nous paraît une bonne indication devant des métatarsalgies rebelles au traitement orthétique ; elle doit porter sur les trois rayons médians, aboutir au plus prés des critères de Maestro et nécessite une autorééducation prolongée et active. Pour citer cette revue : Méd. Chir. Pied 26 (2010). Mots clés Métatarsalgies · Ostéotomie métatarsienneAbstract We report a series of 34 cases of sub-capital, horizontal Weil osteotomies followed up for a mean period of three years. The mean age of the patients was 56.8 years and the majority were female. Access was via a single dorsal, oblique zigzag incision and fixation was performed with standard fixed length screws. Weight bearing was possible at 48 hours because a postoperative resin slipper was employed. Anticoagulation was routine and physiotherapy was commenced on the 15 th day. The Kitaoka score rose from 49.4 points to 74.2 points. Walking distance was greater than 1000 m in 73% of the cases. Big toe mobility reached a mean of 20 of dorsi-flexionand 40 of plantar flexion. The Bristol test was positive in 88% of the cases. We believe that the Weil procedure is appropriate in the treatment of metatarsalgia resistant to orthotic measures. It must be carried out on the three central toes, it should meet Maestro's criteria closely, and it requires prolonged and active self-rehabilitation.To cite this journal: Méd. Chir. Pied 26 (2010).

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Anatomie chirurgicale du pied et de la cheville

Lengelé¹,

Leemrijse²

2015

Pathologie Du Pied Et De La Cheville

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Vascularization of the heads of the three central metatarsals: an anatomical study, its application and considerations with respect to horizontal osteotomies at the neck of the metatarsals

Cited by 7 publications

References 12 publications

Metatarsal Neck Osteotomy with Rigid Internal Fixation for the Treatment of Lesser Toe Metatarsophalangeal Joint Pathology

Metatarsal Neck Osteotomy with Rigid Internal Fixation for the Treatment of Lesser Toe Metatarsophalangeal Joint Pathology

The Weil’s metatarsal osteotomy: about 34 cases at three years follow-up

Anatomie chirurgicale du pied et de la cheville

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