McG 21: Weil Osteotomy Flashcards
1
Q
indications for a Weil
A
- elongated MT w/ a propulsive type hyperkeratotic lesion
- elonagted MT w/ or w/o transverse plane digital deformities
- crossover toes
- subluxation/dislocation of the MTPJs
- RA deformities at the MTPJ
- chronic sub MTPJ busitis
2
Q
Weil is not recommended for
A
- severe sensory neuropathy
- PAD
- surgically induced Charcot
- Diabetic neuroapthy
3
Q
Purpose of a Weil
A
decompression of the MTPJ with relation of the surrounding ST
4
Q
is a PIPJ arthrodesis recommended
A
no, can cause a floating toe
5
Q
T or F: collateral ligaments should be cut off the MT head
A
False
6
Q
where does the osteotomy start
A
1-2mm inferior to the most dorsal aspect of the articular cartilage
7
Q
what degree is the osteotomy
A
~25 degrees (parallel to the ground)
8
Q
what is the normal amount of shortening with cut
A
3-5mm
9
Q
how is the screw placed
A
proximal dorsal to distal plantar to te MT head
10
Q
T or F: the adjacent asymptomatic MT will need to be shortened
A
T - to maintain a normal parabola
11
Q
complications
A
- restricted and painful MTPJ ROM
- recurring transfer lesions
- prominent plantar fixation
12
Q
what is the most common complication
A
floating toe
13
Q
what is the post-op course
A
- PWB
- transfer to shoe in 4-6 weeks
- initiate sagital plane exercises ASAP
