Effectiveness of the Dorsal Thermoplastic Locking Orthosis to Prevent Floating Toes in Postoperative Follow-up of Weil Osteotomies

Background: 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. Objective: This study aimed at assessing the effectiveness of the Tucade dorsal thermoplastic locking orthosis in the prevention of floating toe after Weil osteotomy. Methods: In all, 30 patients with metatarsalgia diagnosis submitted to Weil osteotomy were treated in the postoperative period with the Tucade dorsal thermoplastic locking orthosis. Results: 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. Conclusion: The Tucade dorsal thermoplastic locking orthosis during the postoperative period of Weil osteotomy proved to be effective in the prevention of floating toes.

Level of Evidence: Therapeutic Level IV: Case Series