Weil osteotomy for refer metatarsalgia in hallux valgus / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate the clinical result of Weil osteotomy for refer metatarsalgia in hallux valgus. [Method]Between 2004 and 2005, 25 feet of 17 patients with hallux valgus were treated by osteotomy at the base of the first metatarsal and Weil osteotomy of the lesser metatarsal with metatarsalgia. Weight-bearing anterior-posterior and lateral X ray were taken before the surgery and 6 weeks after surgery on follow up. The hallux valgus angle , the intermetatarsal angle between 1st and 2nd metatarsal, and length of the second metatarsal were measured on the X-ray film. AOFAS system was used to judge the clinical result of the surgery. [Result]The hallux valgus before surgery angle was 32??5.7?,after surgery it was 12.8??3.5?; the intermetatarsal angle between lst and 2nd metatarsal before surgery was 24.2??3.7?,after surgery it was 10.5??0.7?; AOFAS score was 45.6?6.9 before surgery , and 86.9?4.6 after surgery ; significant difference was found between the result. The metatarsal after Weil osteotomy was shorten by 3~8 mm, mean 4.5 mm. After surgery 18 feet had pain free, and 7 feet had a signigicant pain relief . All the patient could return to normal life without other treatment. [Conclusion ] The biomechanical changes in the foot with hallux valgus should be analyzed before surgery . Combined use of base osteotomy at the first metatarsal and Weil osteotomy at lesser metatarsal can get satisfactory clinical result in patients with sever hallux valgus and transferred refer metatarsalgia.