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[Lesser toe deformities].

R A Fuhrmann1

  • 1Lehrstuhl für Orthopädie der Friedrich-Schiller-Universität Jena, am Waldkrankenhaus Rudolf Elle, Jena.

Therapeutische Umschau. Revue Therapeutique
|September 10, 2004
PubMed
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Lesser toe deformities require thorough foot and lower limb assessment. Surgical correction prioritizes the metatarsophalangeal joint, followed by distal joint stabilization for optimal function.

Area of Science:

  • Orthopedic surgery
  • Podiatry
  • Foot and ankle anatomy

Background:

  • Lesser toe deformities commonly cause pain, calluses, and metatarsalgia.
  • A comprehensive clinical evaluation of the entire foot and lower limb is essential for identifying underlying etiologies.

Purpose of the Study:

  • To outline a systematic approach for evaluating and surgically correcting lesser toe deformities.
  • To emphasize the importance of addressing the metatarsophalangeal joint first and prioritizing joint stability for functional outcomes.

Main Methods:

  • Meticulous clinical assessment of the whole foot and lower limb.
  • Evaluation of deformities at all three joint levels (metatarsophalangeal, proximal interphalangeal, distal interphalangeal).
  • Surgical techniques including soft tissue procedures, metatarsal osteotomies, and joint fusions (arthrodeses).

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Main Results:

  • Addressing dorsal subluxation or dislocation of the metatarsophalangeal joint is a critical first step.
  • Correction of distal joint contractures is necessary after metatarsophalangeal joint realignment.
  • Arthrodeses of the proximal and distal interphalangeal joints provide superior stability and function compared to resection arthroplasties.

Conclusions:

  • A stepwise surgical approach, starting with the metatarsophalangeal joint and concluding with distal joint stabilization, is effective for correcting lesser toe deformities.
  • Joint stability, particularly in the distal joints, is paramount for restoring lesser toe function.
  • Arthrodesis is the preferred method for achieving stable and functional outcomes in distal interphalangeal joint correction.