Evolution of the Weil Osteotomy: The Triple Osteotomy

Area of Science:

• Orthopedic Surgery
• Podiatric Medicine
• Biomechanics

Background:

• Weil osteotomy (WO) is the primary surgical method for treating mechanical metatarsalgia globally.
• Indications for WO include propulsive/third rocker metatarsalgia linked to abnormal metatarsal length in the frontal plane.

Purpose of the Study:

• To review the efficacy and evolution of Weil osteotomy for metatarsalgia.
• To discuss complications and advancements in surgical techniques.

Main Methods:

• Review of clinical studies on Weil osteotomy.
• Analysis of surgical variations and their indications.
• Examination of complication rates and management.

Main Results:

• Most clinical studies report good to excellent outcomes following Weil osteotomy.
• Complications like floating toes have driven surgical technique evolution.
• The triple-cut WO allows coaxial shortening without plantar translation of the metatarsal head.

Conclusions:

• Weil osteotomy remains a cornerstone treatment for specific types of metatarsalgia.
• Surgical modifications, such as the triple-cut WO, address known complications and expand treatment options for forefoot disorders.