무지 외반증과 동반된 중족골통 치료를 위한 Weil씨 절골술

Abstract

Purpose: We performed Weil osteotomies for painful callosities under the second and third metatarsal heads that were associated with hallux valgus, and evaluated the outcomes clinically and radiographically. Materials and Methods: From November 2000 through December 2003, we performed Weil osteotomies on 17 patients with painful callosities under the second and third metatarsal heads. The minimum follow-up period was 12 months. For hallux valgus, proximal (13 cases) and distal (4 cases) metatarsal osteotomies were performed. Weil osteotomies was performed in all of the second toes and in 9 of the third toes. For clinical evaluation, we used the American Orthopaedic Foot and Ankle Society's lesser metatarsal and interphalangeal scale (AOFAS LMIS). For radiographic evaluation, we compared the preoperative and postoperative hallux valgus angles (HVAs), intermetatarsal angles (IMAs) and length of the second and third metatarsals. Results: At the last follow-up, all of the plantar callosities were disappeared. The mean AOFAS LMIS scores improved from 57.5 points (range: 40 to 74 points) to 86.5 points (range: 82 to 100 points) postoperatively. The mean HVA was decreased from 38.5° (range: 28 to 48°) to 17.5° (range: 5 to 27°) postoperatively. IMA was decreased 15.7° (range: 0 to 20°) to 6.2° (range: 0 to 11°) postoperatively. Mean decreased second and third metatarsal lengths were 3.3 ㎜ (range: 2 to 5 ㎜) and 2.9 ㎜ (range: 2 to 4 ㎜) respectively. The over-all patients satisfaction rate was 95%. Conclusion: Weil osteotomy is an effective and reliable procedure for the treatment of painful plantar callosities under the second and third metatarsal heads that are associated with hallux valgus.