Godoy-Santos Alexandre Leme, Diniz Fernandes Tulio, Luzo Candida, Ortiz Rafael Trevisan, Sakaki Marcos, Weil Lowell
Department of Orthopedic Surgery, University of São Paulo, Sao Paulo, Brazil (ALGS, TDF, CL, RTO, MS)Weil Foot and Ankle Institute, Des Plaines, IL (LW)
Department of Orthopedic Surgery, University of São Paulo, Sao Paulo, Brazil (ALGS, TDF, CL, RTO, MS)Weil Foot and Ankle Institute, Des Plaines, IL (LW).
Foot Ankle Spec. 2014 Oct;7(5):356-62. doi: 10.1177/1938640014532131. Epub 2014 May 2.
The Weil oblique distal metatarsal osteotomy is regularly used in the treatment of primary metatarsalgia. The most frequent complication is the floating toe, which occurs in up to 36% of postoperative follow-up. The theory of reducing the plantar flexor mechanism tension associated with the retraction of the dorsal structures during the healing process of the surgical procedure may explain this negative evolution.
This study aimed at assessing the effectiveness of the Tucade dorsal thermoplastic locking orthosis in the prevention of floating toe after Weil osteotomy.
In all, 30 patients with metatarsalgia diagnosis submitted to Weil osteotomy were treated in the postoperative period with the Tucade dorsal thermoplastic locking orthosis.
The floating toe was not observed in this case series. There was 1 case of superficial wound irritation at the dorsal surgical incision and 1 case that evolved with transfer metatarsalgia. Statistical analyses were performed-American Orthopaedic Foot and Ankle Society Scale for lateral toes and extension of the lateral toes-using the t test, and P < .0001 was obtained for comparison of the preoperative and postoperative periods in the population studied.
The Tucade dorsal thermoplastic locking orthosis during the postoperative period of Weil osteotomy proved to be effective in the prevention of floating toes.
Therapeutic Level IV: Case Series.
Weil远端跖骨截骨术常用于治疗原发性跖痛症。最常见的并发症是浮趾，在术后随访中发生率高达36%。手术过程愈合过程中，减少与背侧结构回缩相关的跖屈肌机制张力的理论可能解释了这种不良进展。
本研究旨在评估Tucade背侧热塑性锁定矫形器在预防Weil截骨术后浮趾方面的有效性。
总共30例诊断为跖痛症并接受Weil截骨术的患者在术后使用Tucade背侧热塑性锁定矫形器进行治疗。
本病例系列中未观察到浮趾。有1例患者手术切口背侧出现浅表伤口刺激，1例患者出现转移性跖痛症。采用t检验对美国矫形足踝协会外侧足趾评分和外侧足趾伸展情况进行统计分析，研究人群术前和术后比较的P值<0.0001。
Weil截骨术后使用Tucade背侧热塑性锁定矫形器被证明在预防浮趾方面有效。
治疗性四级：病例系列。
