Scarf and Weil Osteotomy

[oscar]

Hi,

I'm on a clinical outpatients placement (still a student) and had a lady today who had a scarf and weil osteotomy in her left big toe (she had a hx of bunions). She's 8 weeks post op and has ok movement (probably 1/2 normal range), strength is good and is walking pretty well on it, she does tend to walk on the lateral side of her foot and has got some general reduced muscle strength of her hip abductors, calf etc on the operated leg so I've given her some exercises for that as well as lots of ankle and foot ROM stuff, and am encouraging her to put weight through her toes when she's standing and walking as her 1st and 2nd toes tend to float in the air when she's standing on it for longer than about 10 secs...

I was wondering if it is possible to mobilise the MTPJ after this type of surgery at this stage?? I just thought I could try that in a few weeks if her range is not improving. It's not a prodecure I know at all and don't have any protocols for this type of surgery! Or is it far too soon for something like that?

Thanks

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[jwilso]

sounds like she is doing ok to me .why has she been referred to physio? in 11 years of working ive never been referred someone following bunionectomy before. shes bound to have mechanical problems as that is probably what caused the bunions in the 1st place. she will have had these problems for many years and so i would doubt you can do that much about them. i have only seen patients follwoing surgery like this when patients have problems with the scar. eg. hypersensitivity. has the patient questioned what she is coming to physio for. good look with this one

[oscar]

No her consultant refered her to us for 'gait re-education' although she's actually walking pretty well, I think she just wanted some re-assurance about whether she's doing ok etc. There was some post-op infection but that cleared up about 6 weeks ago....

thanks for your advice, I have little experience with foot op's so wasn't sure whether her function/mobility was good for the stage she's at