Fleischer AE, et al. - Researchers prospectively estimated consecutive adult individuals who underwent an isolated second Weil metatarsal osteotomy (WMO) or a WMO plus plantar plate repair (WMO + PPR) for sub-second metatarsophalangeal joint pain during a 3.5-year period at our practice. A total of 86 individuals (86 feet: 21 WMO only and 65 WMO + PPR) with a mean age of 61 ± 11 years were included for 1 year. Via the use of the Foot and Ankle Outcome Score and radiographic parabola/alignment of the operative digit preoperatively and postoperatively, individuals were analyzed. No group differences were found in the preoperative or postoperative radiographic parabola, alignment of the second toe, or complication rates. The outcomes of this study demonstrated that when a shortening osteotomy is made, imbricating/repairing and advancing the plantar plate may be important regardless of injury grade in the plate.