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Complications of the Weil osteotomy
Peter Highlander1, Eric VonHerbulis, Aldo Gonzalez
1Barry University School of Podiatric Medicine and Surgery, Miami Shores, Florida, USA. peterdhighlander@gmail.com
Foot & Ankle Specialist
|April 15, 2011
Summary
The Weil osteotomy, a common forefoot surgery, has a high complication rate, with floating toe occurring in 36% of cases. Further research is needed to optimize surgical techniques and reduce adverse outcomes for metatarsalgia treatment.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Podiatric Medicine
Background:
- The Weil osteotomy is a widely utilized surgical procedure for addressing various forefoot pathologies, particularly metatarsalgia.
- Despite its prevalence, the Weil osteotomy is associated with a significant rate of complications, necessitating a review of its outcomes.
Purpose of the Study:
- To systematically review the existing literature on Weil osteotomies.
- To identify and quantify the complication rates associated with the Weil osteotomy procedure.
- To explore potential factors influencing complication rates and suggest areas for future research.
Main Methods:
- A comprehensive literature review was conducted using predetermined inclusion and exclusion criteria.
- Prospective and retrospective studies encompassing multiple surgical indications were included.
- Data from 17 qualifying articles detailing 1131 Weil osteotomies were analyzed for study format, patient demographics, indications, and complication rates.
Main Results:
- Floating toe was the most frequent complication, occurring in 36% (233 cases) of the analyzed Weil osteotomies.
- Recurrence of the original pathology was reported in 15% of cases.
- Other complications included transfer metatarsalgia (7%) and a collective 3% rate for delayed union, non-union, and malunion.
Conclusions:
- The high complication rate associated with the Weil osteotomy underscores the need for careful patient selection and surgical technique.
- There is a lack of consensus on adjunctive procedures, such as prophylactic surgery, plantar plate repair, and interphalangeal arthrodesis, which may impact outcomes.
- Further research is warranted to investigate the influence of these variables on complication rates and to establish best practices for Weil osteotomy.
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