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Updated: Dec 26, 2025

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Minimally invasive correction for symptomatic, fixed curly toe deformity.

Dong Joo Lee1, Jun Young Choi1, Hyung Suh Kim1

  • 1Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea.

Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons
|March 17, 2020
PubMed
Summary

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Minimally invasive surgery effectively corrects symptomatic curly toe deformity. This percutaneous osteotomy technique offers a safe and simple solution for fixed deformities, improving patient function.

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.
Keywords:
Curly toe deformityForefoot disorderMinimally invasive surgeryPercutaneous osteotomy

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  • 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.