For treating various conditions that result in metatarsalgia, the basic aim is to reduce load transmission through the operated metatarsal and reduce pressure on the plantar surface of the metatarsal. The classic Weil osteotomy, recommended for the subluxed or dislocated metatarsal phalangeal joint (MTPJ), is effective for reducing pain.
According to Umur Aydogan, M.D., Penn State Hershey Bone and Joint Institute, “Although Weil osteotomy can be effective, some patients experience complications, like recurrent or transfer metatarsalgia, ‘floating toe,’ avascular necrosis, and stiffness. Some complications may occur because this is an intra-articular procedure.”
Aydogan, along with biomechanical engineering colleagues at Penn State Hershey, has explored an alternative extra-articular procedure to reduce the high plantar pressure associated with metatarsalgia. In a cadaveric model, they compared the effects on plantar pressure following classic and modified Weil osteotomies versus their extra-articular, proximal metatarsal diaphyseal oblique dorsiflexion second metatarsal osteotomy. The findings will be presented at the upcoming annual meeting of the American Orthopedic Foot and Ankle Society (AOFAS).1