Plantar forefoot pressure changes after second metatarsal neck osteotomy

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Podiatry

Background:

• Plantar pressure distribution is crucial for foot function.
• Metatarsal osteotomies are surgical procedures to correct foot deformities.
• The Weil technique is a specific method for metatarsal osteotomy.

Purpose of the Study:

• To evaluate plantar pressure changes following a second metatarsal neck osteotomy.
• To assess the efficacy of the Weil technique in altering pressure distribution.
• To analyze pressure modifications in both static (neutral) and dynamic (heel rise) positions.

Main Methods:

• Utilized six below-knee cadaver specimens.
• Applied a consistent load (500 N) for pressure measurement.
• Employed a computerized pedobarograph to record plantar pressures before and after osteotomy.
• Performed osteotomies at approximately 20 degrees, with 5 mm proximal displacement of metatarsal heads.

Main Results:

• Significant reduction in pressure under the second metatarsal head (36% neutral, 65% heel rise).
• Observed significant pressure decreases under the third (39% neutral, 37% heel rise) and fourth metatarsals (28% neutral).
• Noted a significant pressure increase under the first metatarsal (23% neutral) with no changes under the fifth metatarsal.

Conclusions:

• The Weil metatarsal neck osteotomy effectively offloads pressure from the second metatarsal head.
• The procedure demonstrates consistent pressure reduction in both neutral and heel rise positions.
• This surgical approach shows potential for managing conditions related to excessive pressure on the second metatarsal.