Minimally Invasive Surgery Approach to Lesser Toe Deformities

Percutaneous treatment of lesser toe deformities (LTD) is rapidly gaining popularity due to the safe and effective results of percutaneous forefoot surgery. De Prado was the first to describe a percutaneous approach to LTD combining osteotomies, condylectomies, and selective tenotomies. Since then, many developments in surgical techniques have been described: selective tenotomies and unicortical or bicortical new osteotomies. This article aims to describe the main percutaneous soft tissue and osteotomy techniques, their results and indications. We propose a sequential therapeutic strategy from proximal to distal using decision trees based on the latest published studies and our own experience.