Two modifications of the Weil osteotomy: analysis on sawbone models

Area of Science:

• Orthopedic Surgery
• Podiatric Surgery
• Biomechanics

Background:

• Second metatarsal osteotomies are common procedures in foot surgery.
• Understanding the biomechanical consequences of different osteotomy techniques is crucial for surgical planning and patient outcomes.

Purpose of the Study:

• To evaluate the effects of different second metatarsal osteotomy techniques on bone shortening and metatarsal head displacement.
• To compare bone slice resection versus bone wedge excision in conjunction with proximal displacement of the metatarsal head.

Main Methods:

• Forty sawbone models of the second metatarsal were used.
• Four surgical techniques were simulated: proximal displacement of the head by 5 mm or 10 mm, 5-mm bone slice resection with proximal displacement, and 5-mm dorsally based wedge resection with proximal displacement.
• Measurements of bone shortening and metatarsal head displacement were recorded for each technique.

Main Results:

• Bone slice resection led to significant shortening (16.4+/-1.7 mm) and mild plantar displacement (3.5+/-0.8 mm).
• Bone wedge excision resulted in moderate shortening (7.8+/-0.9 mm) and minimal plantar displacement (0.8+/-1.4 mm).
• Proximal displacement alone without resection also showed varying degrees of shortening and displacement (data not detailed in abstract).

Conclusions:

• Bone wedge excision is a preferable technique to bone slice resection for second metatarsal osteotomies when proximal displacement is intended, due to less bone shortening and plantar displacement.
• These findings have implications for surgical technique selection in procedures involving the second metatarsal to optimize foot biomechanics and prevent complications.