Abstract
Combined transverse and sagittal plane deformities of the second toe represent a common
painful condition encountered by the foot surgeon. After a period of conservative
management, surgical intervention is often required. Historically, a number of surgical
options have been described for the treatment of this condition, with the universal
acknowledgment that an ideal surgical outcome is difficult to achieve and prone to
failure. In this report, a review of previously described surgical techniques is presented,
along with a retrospective analysis of 20 second toe surgical reconstructions, in
16 patients, performed between June 2003 and October 2010. Subjective outcomes were
assessed by means of a mailed questionnaire, and a subset (15 second toes in 11 patients)
returned for follow-up evaluation, including ascertainment of American Orthopaedic
Foot & Ankle Society Clinical Rating System for Lesser Metatarsophalangeal-Interphalangeal
Joint Surgery scores. Overall, the duration of follow-up was 38.25 ± 25.82 months,
and the subset was followed up for 36.07 ± 27.95 months. The preoperative visual analog
pain score was 4.9 ± 2.7, whereas the postoperative pain score was 1.6 ± 2.47 (p < .001). The preoperative American Orthopaedic Foot & Ankle Society score was 44.57
± 17.76, whereas the postoperative score was 91.27 ± 12.27 (p < .001). Based on the results of this investigation, pairing a basilar proximal phalangeal
osteotomy with arthrodesis of the proximal interphalangeal joint, for correction of
combined transverse and sagittal plane deformities, appears to yield satisfactory
long-term results.
Level of Evidence
Keywords
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Article info
Publication history
Published online: August 22, 2011
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
