This is a break (osteotomy) created in one or more of the forefoot bones which allows shortening them. The shortening means that this bone takes less weight. It is particularly useful to correct overloading of one or more bones in the forefoot.

 

Why do you need this operation?

Before being offered this operation, you should have tried other measures such as using moulded insoles and well cushioned shoe-wear.

This operation is offered to you if you continue to have symptoms despite trying the above measures and after you have been examined and counseled.

What does the operation involve?

The operation is done as a day case, but come prepared in case you need to stay overnight.

The operation is performed with general anaesthetic and nerve block (which means numbing the nerves of the foot).

The operation involves an incision on the top of the forefoot through which one or two joints are explored. A break (osteotomy) in the bone is pefromed to translate the head proximal so as to shorten the overall length of the bone.

You will use crutches if needed as well as a surgical shoe “the off-loading shoe”.

The example below shoes the prominent 2nd and 3rd rays that were shortened with the Weil osteotomy.

Before                                 After

Your post-operative period

1. •You must keep your foot raised for the first two weeks and if needed afterwards
   

2. •You can put your full weight on your foot using the surgical shoe for the first 6 weeks
   

3. •Use crutches if needed
   

4. •The swelling may last for up to six months.
   

Your follow-up

1. •At two weeks the dressing is reduced and the stitches are removed
   

2. •At 6 - 8 weeks you have a follow-up with x-rays
   

3. •Off work for about six weeks depending on your job
   

4. •No driving for six - eight weeks.
   

What are the possible complications?

1. •Infection
   

2. •Sensitive or painful scar
   

3. •Big toe permanent numbness
   

4. •Joint stiffness
   

5. •Under-correction or Over-correction
   

6. •Failure of bone healing (non-union)
   

7. •Recurrence of the deformity
   

8. •Avascular Necrosis of metatarsal head
   

9. •Clots in the leg (DVT)
   

10. •Clots in the lung (PE)
    

11. •Chronic Regional Pain Syndrome
    

Smoking, diabetes, rheumatoid arthritis or being on steroids or blood thinning medication increases possible risks significantly.