Metatarsalgia: distal metatarsal osteotomies

Area of Science:

• Orthopedics
• Podiatry
• Surgical Innovation

Background:

• Metatarsalgia is characterized by pain at the metatarsophalangeal (MTP) joints.
• Differential diagnosis is crucial to exclude conditions like Morton's neuroma, which cause abnormal pressure distribution and pain.
• Conservative treatments include footwear modifications, metatarsal pads, and orthoses.

Purpose of the Study:

• To evaluate the effectiveness of surgical interventions for metatarsalgia when conservative treatments fail.
• To highlight metatarsal osteotomies as a viable surgical option.
• To specifically assess the distal metatarsal oblique osteotomy (Weil osteotomy) for metatarsalgia management.

Main Methods:

• Review of outcome studies and biomechanical analyses of distal metatarsal osteotomies.
• Focus on the Weil osteotomy and its modifications.
• Analysis of the surgical technique's role in addressing MTP joint subluxation or dislocation.

Main Results:

• Lesser metatarsal osteotomy is an effective and accepted treatment for metatarsalgia.
• The Weil osteotomy is well-evaluated, offering positive outcomes.
• This procedure decreases symptomatic metatarsal head prominence and corrects deformities contributing to metatarsalgia.

Conclusions:

• Surgical reconstruction, particularly metatarsal osteotomies, should be considered if conservative metatarsalgia treatments are unsuccessful.
• The Weil osteotomy is a leading surgical technique for managing metatarsalgia, effectively decompressing the MTP joint and reducing pain.
• This surgical approach addresses the underlying biomechanical issues causing pain and deformity.