Weil Osteotomy

This procedure is performed to reduce forefoot pain by shortening the length of the metatarsal or metatarsals (the bones of the forefoot). This spreads weight more evenly through the forefoot.

Weil osteotomy surgery involves:

• General anaesthetic, intravenous antibiotics
• Incision on top of forefoot
• Dissection down to metatarsal
• Shortening of the metatarsal
• Insertion of screw
• X-ray to check position
• Wound closure

All surgical procedures carry some risk. Fortunately the risk of complications with a Weil osteotomy is relatively low. Some of the risks of surgery include:

• Infection
• Problems with wound healing
• Non-union of bone
• Nerve injury causing numbness, tingling and/or pins and needles
• Blood vessel injury
• Periprosthetic fracture
• Deep venous thrombosis/pulmonary embolism (the risk of DVT increases with smoking, the oral contraceptive pill, hormone replacement therapy, immobility and obesity)
• Ongoing pain
• Anaesthetic complications
• Drug allergy

Rest

• You will have a shoe on your foot. Keep foot elevated as much as possible, especially for initial 72 hours. Keep dressings dry and intact until post operative appointment.
• Mobilise short distances as pain allows, aim to remain in your own home for the first few weeks limiting long periods of standing or mobilising
• Bear weight as tolerated in the post surgical shoe

Pain

• Pain relief may be required for up to 4 weeks; depending on your other medications this may include:
• Regular paracetamol, anti-inflammatory drugs and break through opiate type medications

Driving

• Any surgery performed on the right foot or both feet will mean no driving for a minimum of 6 weeks
• If surgery was performed on the left foot then driving in an automatic is possible, but Dr Phegan would recommend waiting a minimum of two weeks before attempting to drive

Driving any vehicle with a cast or boot is potentially hazardous and you should consider this before getting behind the wheel.

Follow up

• Keep all dressings dry and intact for the first two weeks
• Removal of stitches/sutures typically occurs at an appointment with Dr Phegan and his in-house therapists at 10-14 days at first post operative appointment. Very occasionally some sutures need to stay in for longer
• Your appointment will be booked by Dr Phegan and a confirmatory SMS will be sent informing you of the time and date for follow up

Typical milestones

• 2 weeks: Wound review and removal of sutures
• 2-6 weeks: regular physiotherapy to increase range of motion
• 6 weeks to 3 months: work on swelling reduction, scar massage and mobility
• Full recovery 6 months

Every patient's recovery is individual and depends on the severity of the injury and the complexity of the surgery.