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A Weil osteotomy is a shortening osteotomy of a lesser metatarsal, most commonly performed for metatarsalgia or instability at a metatarsophalangeal joint. The surgeon makes a controlled cut through the metatarsal head and shifts the head backward to reduce pressure beneath the forefoot. The new position is commonly held with a small screw. The procedure can also create access for plantar plate repair when instability is present.
read more about weil osteotomy ...The operation is used when one or more lesser metatarsals are overloaded and cause persistent plantar forefoot pain, callus formation, joint instability, or toe deformity. It can be considered when nonsurgical treatment such as footwear modification, pads, orthoses, and activity changes has not provided enough relief. Surgeons evaluate metatarsal length, toe alignment, plantar plate integrity, joint stability, and the overall forefoot pattern before choosing the procedure. A Weil osteotomy is often combined with plantar plate repair or hammertoe correction when soft-tissue instability contributes to the problem.
The surgeon exposes the affected metatarsophalangeal joint through a dorsal incision and makes an oblique cut through the metatarsal head. The head fragment is translated proximally by the planned amount to shorten the metatarsal and reduce plantar pressure. A screw or other fixation holds the fragment in position while the bone heals. The surgeon can then repair the plantar plate, correct a hammertoe, or address other associated deformity when needed.
The foot is protected in a postoperative shoe, boot, or other support while the osteotomy heals. Weight-bearing instructions depend on fixation, the amount of shortening, and any plantar plate or toe procedures performed at the same time. Swelling and stiffness at the metatarsophalangeal joint can continue for several months. Toe motion, gait, and forefoot loading are progressed gradually as bone and soft-tissue healing permit.
Possible complications include infection, swelling, stiffness, hardware irritation, delayed healing, malunion, and persistent metatarsalgia. Floating toe, in which the treated toe does not rest normally on the floor, is a well-recognized complication of the Weil osteotomy. Excessive shortening can shift pressure to adjacent metatarsals and cause transfer metatarsalgia. Recurrent instability, joint stiffness, or painful hardware can require additional treatment or surgery.
It is commonly used for painful overload beneath a lesser metatarsal head and can also help treat metatarsophalangeal joint instability or dislocation.
Yes. The metatarsal head is shifted backward after the bone cut, reducing the effective length of the metatarsal and changing forefoot pressure.
Yes. The osteotomy can improve access to the plantar plate and reduce pressure across the repaired joint when instability or a plantar plate tear is present.
Floating toe means the treated toe does not contact the floor normally when standing. It can result from changes in tendon balance, joint position, or postoperative stiffness.
Lesser Metatarsal - Shortening Surgery for Pain Relief. FootCareMD, American Orthopaedic Foot & Ankle Society. https://www.footcaremd.org/foot-and-ankle-treatments/midfoot/lesser-metatarsal-shortening-osteotomy. Date Accessed August 13, 2026.
Complications of the Weil osteotomy. PubMed. https://pubmed.ncbi.nlm.nih.gov/21490179/. Date Accessed August 13, 2026.
Evolution of the Weil Osteotomy: The Triple Osteotomy. PubMed. https://pubmed.ncbi.nlm.nih.gov/31653365/. Date Accessed August 13, 2026.
Incidence of and Functional Significance of Floating Toe After Weil Osteotomy. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC8697231/. Date Accessed August 13, 2026.
Anatomic plantar plate repair using the Weil metatarsal osteotomy approach. PubMed. https://pubmed.ncbi.nlm.nih.gov/21421939/. Date Accessed August 13, 2026.