title: Effectiveness of the dorsal thermoplastic locking orthosis to prevent floating toes in postoperative follow-up of Weil osteotomies: pilot study.
abstract: 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.
  
  
  CONCLUSIONS
  The Tucade dorsal thermoplastic locking orthosis during the postoperative period of Weil osteotomy proved to be effective in the prevention of floating toes.
  
  
  METHODS
  Therapeutic Level IV: Case Series.
authors.affiliation: 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) alexandrelemegodoy@usp.br.
authors.forename: Alexandre Leme
authors.initials: AL
authors.lastname: Godoy-Santos
authors.affiliation: 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).
authors.forename: Tulio
authors.initials: T
authors.lastname: Diniz Fernandes
authors.affiliation: 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).
authors.forename: Candida
authors.initials: C
authors.lastname: Luzo
authors.affiliation: 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).
authors.forename: Rafael Trevisan
authors.initials: RT
authors.lastname: Ortiz
authors.affiliation: 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).
authors.forename: Marcos
authors.initials: M
authors.lastname: Sakaki
authors.affiliation: 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).
authors.forename: Lowell
authors.initials: L
authors.lastname: Weil
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000517:prevention & control*; D037061:Metatarsalgia / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D009989:Orthotic Devices; D010027:Osteotomy / Q000379:methods*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D014034:Toes / Q000601:surgery*
keywords: floating toes; metatarsalgia; orthosis; osteotomy