Clinical and radiological outcomes after Weil osteotomy compared to distal metatarsal metaphyseal osteotomy in the treatment of metatarsalgia-A prospective study

Abstract

Background: The distal metatarsal metaphyseal osteotomy (DMMO) may have lower complication rates than the Weil osteotomy (WO) due to its extraarticular location and its minimal invasive nature. This study compares the clinical and radiological outcomes and complications after DMMO and WO.

Methods: We compared 30 patients with WO (Group A) to 30 patients with DMMO (Group B). Ten males and 50 females with a mean age of 57.7 were included. 45 WOs and 73 DMMOs were evaluated in 60 patients. Allocation to Group A or B were random, indications comparable. The outcome was measured clinically using the Visual Analogue Scale Foot and Ankle and radiologically with an average follow up period of 13 months.

Results: Clinical examination six weeks postoperatively showed swelling of the forefoot in 66.7% for Group A and in 73.3% for Group B. Swelling subsided in the course of time, but postoperative stiffness, lack of toe purchase and range of motion deficits did not change in the course of time. All osteotomies healed. The VAS-FA improved for both groups. Tourniquet time and operating time were lower and radiation doses higher in Group B.

Conclusions: The DMMO resulted in a comparable patient satisfaction and comparable radiological healing compared to WO and appears to be a valid alternative to the WO.

Keywords: DMMO; Distal metatarsal metaphyseal osteotomy; Distal metatarsal minimally invasive osteotomy; Distal metatarsal osteotomy; Metatarsalgia; Weil osteotomy.