title: Weil osteotomy: assessment of medium term results and predictive factors in recurrent metatarsalgia.
abstract: BACKGROUND
  The angle of the Weil osteotomy is usually referenced relative to the floor irrespective of the plantar angulation of the metatarsal. This study aims to analyse the long term results following the Weil osteotomy and identify the cause of poor outcome.
  
  
  METHODS
  This study presents a retrospective review of 61 patients (86 feet), with mean follow-up of 31 months. Each patient underwent clinical, pedobarographic and radiological examination. The radiographs obtained included 'Metatarsal Skyline Views' (MSV), to assess the plantar declination of the metatarsal heads following the osteotomy. The functional scoring was performed using AOFAS and Foot Function Index.
  
  
  RESULTS
  Fifty-five patients (80 feet) showed good to excellent results clinically. Six patients had persistent metatarsalgia. All these 6 patients had callosities beneath metatarsal heads. Pedobarography showed peak pressures in the same distribution as callosities and the MSV showed increased plantar declination of the metatarsal heads. This correlation was found to be significant (p<0.05).
  
  
  CONCLUSIONS
  The Weil osteotomy is a safe and effective treatment for metatarsalgia. An MSV radiograph is helpful to identify the plantar prominence of metatarsal which can be associated with poor clinical outcomes.
authors.affiliation: Trauma & Orthopaedics, University Hospital of Wales, Heath Park, Cardiff, UK. ashish.khurana@doctors.org.uk
authors.forename: A
authors.initials: A
authors.lastname: Khurana
authors.forename: S
authors.initials: S
authors.lastname: Kadamabande
authors.forename: S
authors.initials: S
authors.lastname: James
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Hariharan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D037061:Metatarsalgia / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult