Weils osteotomy (using Othosolutions forefoot reconstruction system, FRS)
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The Weils’ osteotomy is an effective, technically straightforward and reproducible way of reducing plantar metatarsal head pain due to mechanical overload. The metatarsal length is slightly shortened as well as the head elevated by the technique.
Less commonly it can be indicated to deal with degenerate change from the lesser metatarso-phalangeal joints.
It is important to preserve (or reconstruct) an appropriate “metatarsal arcade” whereby from lateral to medial each adjacent metatarsal is slightly longer than its fellow when viewed in the axial plane. Failure to do this will usually transfer mechanical pain down the line laterally to the next longest metatarsal.
A Weils osteotomy is often performed part of a more general forefoot reconstruction, in patients with a hallux valgus and transfer metatarsalgia.
Author: Mark Herron, FRCS.
Institution: The Wellington Hospital, London.