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I referred a patient with a NV back to her GP as she was with BUPA, thinking that they would do a deep debridment etc. I received a phone call to say that she was going to have a Weils osteotomy.
Has anyone got any experience with the success of this OP and is this a "step to far"

 

NV to GP with BUPA.
Hmmmmmm
Weil Osteotomies (WO for you) are very successful and have several variations.

Steve (a.k.a. SA, DPM, FACFAS)

 

Steve - RALMAO!

OK, to Eric (a.k.a the OP) the Weil osteotomy (or WO as Steve has already said) may be of benefit if this patient has a painful plantar neurovascular corn (NV) related to an altered metatarsal parabola and success rates vary from surgeon to surgeon and patient to patient. Sometimes patients can get floating toes or transfer lesions post op (PO), but these are not standard and would be regarded as post op (PO) complications (C).

TTFN,

Lee (sorry, that's not an acronym - it's my name)

 

Hello Eric

I take it that you are in the U.K.

I agree with the points made by both Steve and Lee. Lowell Weil - a highly respected podiatric surgeon from the USA - originated this procedure. It consists of a shallow oblique cut through the metatarsal from distal dorsal to plantar proximal. the distal fragment is then displaced proximally and fixed either by wires or screws. Because of the angle of declination of the metatarsals the proximal placement also results in dorsal displacement hence reducing pressure under the met head. As Lee has mentioned, a long met will also result in excessive plantar declination of the head which is why this procedure is usually successful in cases of unusual metatarsal parabolas. The adverse outcomes are as he states. I have often found post-operative strapping of the relevant toe in plantarflexion is useful in minimising 'floating toe' and I am sure you can help your patient here. If the GP has referred to a podiatric surgeon why not get involved? Give him/her a ring; you might get to see the op. and maybe deal with some of the post-op. care.

All the best

Bill liggins