Minimally invasive correction for symptomatic, fixed curly toe deformity

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Pediatric Orthopedics

Background:

• Curly toe deformity is a common condition affecting the 4th and 5th toes.
• Symptomatic and fixed cases often lack established treatment options.
• Open surgical techniques have limitations, prompting the need for alternative methods.

Purpose of the Study:

• To evaluate the efficacy of minimally invasive dorsolateral closing wedge-shaped osteotomy for symptomatic, fixed curly toe deformity.
• To assess clinical and radiological outcomes following the procedure.

Main Methods:

• 25 patients with symptomatic, fixed curly toe deformity underwent percutaneous dorsolateral closing wedge-shaped osteotomies.
• Osteotomies were performed at the proximal and/or middle phalanx using Shannon burrs.
• Postoperative assessments included clinical evaluation and radiological measurements at a mean follow-up of 22.51 months.

Main Results:

• Osteotomies were performed on the middle phalanx (10 cases), proximal phalanx (13 cases), and both (1 case).
• Significant mean corrections were achieved: 16.54° for varus inclination and 2.24 mm for shortening.
• Foot and Ankle Ability Measure Activities of Daily Living scores improved significantly from 59.09 to 74.55.
• Minor complications included one pin site infection and one case of digital nerve injury causing numbness.

Conclusions:

• Minimally invasive dorsolateral closing wedge-shaped osteotomy is a safe and effective treatment for symptomatic, fixed curly toe deformity.
• The technique provides reliable correction with good functional outcomes.
• This approach offers a simple and minimally invasive alternative to traditional open surgeries.