RE: Medially Deviated 2nd toe (Zung Q. Le, DPM)
From: Lowell Weil, Jr., DPM, MBA
While I agree with Zung Q. Le, DPM that a
crossover toe deformity can be successfully
addressed with the Weil metatarsal osteotomy
(WMO), I want to point out that Dr. Le's
description of the osteotomy may be his own
modification, but not a true representation of
the Weil osteotomy.
The Weil osteotomy, named by Samuel Barouk, MD
of Bordeaux, France is an oblique osteotomy of a
lesser metatarsal starting in the dorsal 1-2 mm
of the articular surface of the metatarsal and
angulated at an approximately 15 degree angle
proximally. The most basic WMO is used to
shorten an elongated metatarsal 1-3 mm that has
become painful during the propulsive phase of
gait. The purpose of this very small angle is
to prevent plantarization of the metatarsal head
while shortening. It also allows for ease of
fixation and immediate weight bearing. There
are many modifications of the WMO that have been
described to address plantar lesions, crossover
toe deformity, dislocation of the MPJ, and
rheumatoid arthritis to name several.
Lowell Weil, Jr., DPM, MBA
Weil Foot & Ankle Institute
