The Conventional Weil Osteotomy Does Not Require Screw Fixation.

Area of Science:

• Orthopedic surgery
• Podiatric surgery
• Biomechanics

Background:

• The Weil osteotomy is a common surgical procedure for chronic metatarsalgia.
• Traditionally, screw fixation is used to stabilize the osteotomy site.
• The necessity of screw fixation in Weil osteotomies requires further investigation.

Purpose of the Study:

• To evaluate the necessity of screw fixation in Weil osteotomies.
• To compare clinical outcomes and revision rates between Weil osteotomies with and without screw fixation.
• To determine if screw fixation impacts patient satisfaction and functional recovery.

Main Methods:

• Retrospective analysis of 155 patients (278 Weil osteotomies) between 2016 and 2021.
• Patients were divided into two groups: screw fixation (Group A) and no screw fixation (Group B).
• Data collected included demographics, Visual Analog Scale Foot and Ankle (VAS-FA), SF-12 questionnaire, and toe mobility, with a mean follow-up of 4.5 years.

Main Results:

• No significant difference in clinical outcomes (VAS-FA, SF-12 scores) between groups.
• Overall revision rate was 20% (25% in Group A, 10.2% in Group B).
• Group A had a significantly higher revision rate, primarily for metatarsophalangeal joint arthrolysis.

Conclusions:

• Screw fixation is not consistently necessary for Weil osteotomies.
• Omitting screw fixation may lead to lower revision rates without compromising clinical outcomes or patient satisfaction.
• This study challenges the routine use of screw fixation in Weil osteotomies.