{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:44:01Z","timestamp":1783035841376,"version":"3.54.6"},"reference-count":23,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[1999,2,1]],"date-time":"1999-02-01T00:00:00Z","timestamp":917827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[1999,2]]},"abstract":"<jats:p>We retrospectively reviewed the outcome of 30 patients who were treated surgically for metatarsalgia resulting from dislocation of one or more lesser metatarsophalangeal (MTP) joints. We used two treatments, including an osteotomy of the metatarsal head (Weil osteotomy, N = 15) or an osteotomy of the metatarsal shaft (Helal osteotomy, N = 15). Before surgery, all patients had been treated with various nonoperative modalities for a minimum of 6 months. Between 1991 and 1993,15 consecutive patients underwent a Helal osteotomy (22 metatarsals), and 15 consecutive patients were subsequently treated between 1994 and 1995 with a Weil osteotomy (25 metatarsals). All patients were evaluated clinically and radiographically at a mean follow-up period of 22 months (range, 12\u201339 months), noting especially persistent subluxation or dislocation, recurrent metatarsalgia, and transfer lesions. Patients managed with a Weil osteotomy had significantly higher satisfaction ( P = 0.049), lower incidence of recurrent metatarsalgia (0 vs 27%, P = 0.107), and fewer transfer lesions (0 vs 41%, P = &lt;0.001) than those managed with a Helal osteotomy. Furthermore, those managed with the Weil procedure had a higher percentage of radiographic reduction and maintenance of the MTP joint dislocation (21 of 25, 84% vs 8 of 22,36% P = 0.002) than those managed with the Helal procedure. In the Weil group, there was also no malunion or pseudoarthrosis; in the Helal group there were five malunions and three pseudoarthroses.<\/jats:p>\n                  <jats:p>Although the follow-up period for the Weil osteotomy (15 months) was shorter than that for the Helal osteotomy (26 months), the former group had higher American Orthopaedic Foot and Ankle Society forefoot scores, which were significantly different from the results attained with the Helal osteotomy. A telephone update was performed on the Weil osteotomy group at an average of 27 months postsurgery, and no patient had experienced changes since the clinical follow-up. We concluded that the Weil procedure is a satisfactory method for correcting metatarsalgia caused by dislocation of the MTP joint and that, because of the high complication rate, the Helal osteotomy is not an acceptable procedure for correcting this condition.<\/jats:p>","DOI":"10.1177\/107110079902000202","type":"journal-article","created":{"date-parts":[[2013,3,3]],"date-time":"2013-03-03T03:31:12Z","timestamp":1362281472000},"page":"72-79","source":"Crossref","is-referenced-by-count":142,"title":["Comparison of the Results of the Weil and Helal Osteotomies for the Treatment of Metatarsalgia Secondary to Dislocation of the Lesser Metatarsophalangeal Joints"],"prefix":"10.1177","volume":"20","author":[{"given":"Hans-J\u00f6rg","family":"Trnka","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Hospital Gersthof, Vienna, Austria."},{"name":"Department of Orthopaedic Surgery, The Union Memorial Hospital, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"M\u00fchlbauer","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital Gersthof, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Zettl","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital Gersthof, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Myerson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Union Memorial Hospital, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ritschl","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital Gersthof, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1999,2,1]]},"reference":[{"key":"bibr1-107110079902000202","unstructured":"1. Barouk L.S.: Weil head-neck oblique osteotomies: possibilities. Presented at Techniques of Osteotomies on the Forefoot, Bordeaux (France), October 20\u201322, 1994."},{"key":"bibr2-107110079902000202","first-page":"391","volume":"18","author":"Bitzan P.","year":"1997","journal-title":"Plantar pressure distribution after resection of the metatarsal heads in rheumatoid arthritis"},{"key":"bibr3-107110079902000202","first-page":"535","volume":"20","author":"Coughlin M.J.","year":"1989","journal-title":"Subluxation and dislocation of the second metatarsophalangeal joint"},{"key":"bibr4-107110079902000202","first-page":"10","volume":"9","author":"Cracchiolo A.","year":"1988","journal-title":"Silicone implant arthroplasty for second metatarsophalangeal joint disorders with and without hallux valgus deformities"},{"key":"bibr5-107110079902000202","first-page":"728","volume":"160","author":"DuVries H.L.","year":"1956","journal-title":"Dislocation of the toe [letter]"},{"key":"bibr6-107110079902000202","first-page":"61","volume":"40","author":"Giannestras N.J.","year":"1958","journal-title":"Shortening of the metatarsal shaft in the treatment of plantar keratosis: an end-result study"},{"key":"bibr7-107110079902000202","first-page":"303","volume":"10","author":"Harper M.C.","year":"1990","journal-title":"Dorsal closing wedge metatarsal osteotomy: a trigonometric analysis"},{"key":"bibr8-107110079902000202","first-page":"187","volume":"57","author":"Helal B.","year":"1975","journal-title":"Metatarsal osteotomy for metatarsalgia"},{"key":"bibr9-107110079902000202","first-page":"213","volume":"66","author":"Helal B.","year":"1984","journal-title":"Telescoping osteotomy for pressure metatarsalgia"},{"key":"bibr10-107110079902000202","first-page":"247","volume":"10","author":"Leventen E.O.","year":"1990","journal-title":"Distal metatarsal osteotomy for intractable plantar keratoses"},{"key":"bibr11-107110079902000202","first-page":"69","volume":"1","author":"Mulier T.","year":"1994","journal-title":"Long-term functional results after the Helal osteotomy"},{"key":"bibr12-107110079902000202","unstructured":"12. Myerson M.: Metatarsal osteotomy.\n                      In\n                      Myerson M. (ed.), Current Therapy in Foot Ankle Surgery, St. Louis, Mosby-Year Book, 1993, pp. 153\u2013158."},{"key":"bibr13-107110079902000202","first-page":"7","volume":"9","author":"Pedowitz W.J.","year":"1988","journal-title":"Distal oblique osteotomy for intractable plantar keratosis of the middle three metatarsals"},{"key":"bibr14-107110079902000202","unstructured":"14. Phillips A.J., and Corey S.V.: Power instrument skills.\n                      In\n                      McGlamry E.D., Banks A.S., and Downey M.S. (eds.), Comprehensive Textbook of Foot Surgery, Ed. 2. Baltimore, Williams & Wilkins, pp. 72\u2013101, 1992."},{"key":"bibr15-107110079902000202","first-page":"272","volume":"120","author":"Sarfert D.","year":"1982","journal-title":"Treatment of splayfoot with prolapse of the metatarsal heads by Helal's Oblique Metatarsal Osteotomy (author's transl)"},{"key":"bibr16-107110079902000202","first-page":"322","volume":"127","author":"Schmidt K.","year":"1989","journal-title":"Treatment of splay foot with the Helal metatarsal osteotomy"},{"key":"bibr17-107110079902000202","first-page":"30","volume":"4","author":"Sclamberg E.L.","year":"1983","journal-title":"A dorsal wedge V osteotomy for painful plantar callosities"},{"key":"bibr18-107110079902000202","first-page":"229","volume":"1","author":"Scranton P.E.","year":"1981","journal-title":"Metatarsalgia: a clinical review of diagnosis and management"},{"key":"bibr19-107110079902000202","first-page":"457","volume":"19","author":"Trnka H.J.","year":"1996","journal-title":"Helal metatarsal osteotomy for the treatment of metatarsalgia: a critical analysis of results"},{"key":"bibr20-107110079902000202","unstructured":"20. Viladot A.Sr.: The metatarsals.\n                      In\n                      Jahss M.H. (ed.), Disorders of the Foot Ankle: Medical and Surgical Management, Ed. 2. Philadelphia, WB Saunders, pp. 1229\u20131268, 1991."},{"key":"bibr21-107110079902000202","unstructured":"21. Weil L.S.: Weil head-neck oblique osteotomy: technique and fixation. Presented at Techniques of Osteotomies on the Forefoot, Bordeaux (France), October 20\u201322, 1994."},{"key":"bibr22-107110079902000202","first-page":"556","volume":"127","author":"Winkler H.","year":"1989","journal-title":"Helal's metatarsal osteotomy: indication and technic with reference to shape and function of the foot"},{"key":"bibr23-107110079902000202","first-page":"2","volume":"9","author":"Winson I.G.","year":"1988","journal-title":"Treatment of metatarsalgia by sliding distal metatarsal osteotomy"}],"container-title":["Foot &amp; Ankle International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/107110079902000202","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/107110079902000202","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/107110079902000202","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:19:01Z","timestamp":1777411141000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/107110079902000202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,2]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1999,2]]}},"alternative-id":["10.1177\/107110079902000202"],"URL":"https:\/\/doi.org\/10.1177\/107110079902000202","relation":{},"ISSN":["1071-1007","1944-7876"],"issn-type":[{"value":"1071-1007","type":"print"},{"value":"1944-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,2]]}}}