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Toe component excision in postaxial polydactyly of the foot
Gi Heon Park1, Sung Taek Jung, Jae Yoon Chung
1Department of Orthopedic Surgery, Chonnam National University Hospital, Gwangju, Korea.
Foot & Ankle International
|March 2, 2013
Summary
Surgical treatment for postaxial polydactyly effectively addresses congenital fifth toe malformations. A new toe selection algorithm and medial toe excision technique yield satisfactory functional and cosmetic results.
Area of Science:
- Orthopedic surgery
- Congenital malformations
- Foot and ankle surgery
Background:
- Postaxial polydactyly of the fifth toe is a common congenital forefoot malformation.
- Current surgical treatment lacks a standardized approach for toe component excision.
- This study aimed to evaluate operative outcomes and establish treatment guidelines for postaxial polydactyly.
Observation:
- A retrospective review of 27 patients (36 feet) with postaxial polydactyly treated between 2004 and 2010 was conducted.
- Morphological and radiological assessments were used to determine the dominant toe for selection.
- Surgical techniques included dorsal rectangular flaps with skin grafts for medial toe excision and racket-shaped incisions for lateral toe excision.
Findings:
- Overall surgical outcomes were satisfactory, with only minor complications related to skin grafts.
- While 18 reconstructed toes were smaller than normal, significant valgus deformity occurred in only 3 cases.
- The medial toe excision technique and toe selection algorithm demonstrated success in meeting patient needs.
Implications:
- The study provides a validated algorithm for selecting the dominant toe in postaxial polydactyly cases.
- The described medial toe excision technique offers a reliable method for functional and aesthetic reconstruction.
- These findings can guide orthopedic surgeons in managing postaxial polydactyly, improving patient outcomes.
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