Metatarsal Osteotomy for the Treatment of Chronic Metatarsalgia: A Clinical, Radiological and Pedobarographic Analysis

Introduction: Metatarsalgia is a widespread symptom complex with demanding treatment. The Weil osteotomy and the distal minimally invasive metatarsal osteotomy (DMMO) are both considered appropriate surgical treatment modalities and have been shown to result in comparable outcomes in previous studies. Materials and Methods In this retrospective study, 77 patients with chronic metatarsalgia were included. 41 patients (44 feet) received DMMO and 36 patients (40 feet) received Weil osteotomy. They followed clinical, radiological, and pedobarographic examination in a comparative study. Results Compared to DMMO, Weil osteotomy seems to result in a higher rate of wound healing disorders and wound infections. The appearance of floating toes tended to be higher in the Weil-group without reaching a statistically significant level. Improvement in postoperative AOFAS score was comparable in both groups.Pedobarographically, the DMMO group showed a particularly decrease of metatarsal peak pressure and a favorable shifting in the pressure-time integral. Conclusion DMMO and Weil osteotomy equally improved AOFAS and FFI Scores. The pedobarographic results indicated a significantly better postoperative pressure redistribution after DMMO compared to Weil osteotomy. DMMO was advantageous regarding the rate of wound healing impairments making it an attractive procedure in patients with risk profile.