Weil Osteotomy Drawbacks

Secondary malunion or metatarsal head necrosis are almost not observed with this procedure.

Transfer metatarsalgia can be avoided by respecting the metatarsal relative lengths, both in a dorso-plantar and in a medial oblique view. At last, care has to be taken to respect the relative length between the first and the lesser metatarsals; the combined first metatarsal shortening may be performed if required. On the other hand, the double layer is extremely useful to avoid most of the drawbacks.

First Metatarsal

Fig. 17d. Weil osteotomy drawbacks.

1. Secondary malunion can be avoided by better fragmental contact provided by the second layer (2) and a strong fixation (one screw, one soc pin).

3. When a single metatarsal osteotomy is performed, the fixation has to be particularly strong, to avoid secondary proximal sliding, which results in transfer metatarsalgia. Anyway, an isolated shortening of one metatarsal is often delicate. To illustrate this, a notice picked out from a level crossing in France: The text is "don't cross without looking in the two directions: a train could hide another one" (4). 5, 6, 7. If the first ray is not shortened (or not enough), loss of toe ground contact or remaining claw toe may be observed, mainly because of the anastomosis between the flexor hallucis longus and the common flexor digitarum tendon. This test allows to explain and to assess the necessity of cutting this anastomosis by a separated medial foot approach (pictures by courtesy of P. Diebold). In France it is called "syndrome de l'attelage".

Fig. 17d. Weil osteotomy drawbacks.

1. Secondary malunion can be avoided by better fragmental contact provided by the second layer (2) and a strong fixation (one screw, one soc pin).

3. When a single metatarsal osteotomy is performed, the fixation has to be particularly strong, to avoid secondary proximal sliding, which results in transfer metatarsalgia. Anyway, an isolated shortening of one metatarsal is often delicate. To illustrate this, a notice picked out from a level crossing in France: The text is "don't cross without looking in the two directions: a train could hide another one" (4). 5, 6, 7. If the first ray is not shortened (or not enough), loss of toe ground contact or remaining claw toe may be observed, mainly because of the anastomosis between the flexor hallucis longus and the common flexor digitarum tendon. This test allows to explain and to assess the necessity of cutting this anastomosis by a separated medial foot approach (pictures by courtesy of P. Diebold). In France it is called "syndrome de l'attelage".

Was this article helpful?

0 0
How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

Get My Free Ebook


Post a comment