Abstract:
OBJECTIVE:Realignment of medially deviated lesser toes II-IV via subligamentous transfer of the extensor digitorum brevis tendon to treat painful toe disorders. INDICATIONS:Flexible medial malalignment of the lesser toes II-IV attributed to transverse instability of the metatarsophalangeal joint. CONTRAINDICATIONS:Contract lesser toe deformities. Medial malalignment due to an osseous pathology or instability of the proximal interphalangeal joint. Neuropathy. Infection. SURGICAL TECHNIQUE:Regional anesthesia. Patient in supine position. Dorsal S-shaped skin incision at the metatarsophalangeal joint. Medial split of the extensor hood. Dorsomedial capsular release. Distal tenotomy of the extensor digitorum brevis tendon. Transfer of the tendon slip beneath the intermetatarsal ligament to the lateral aspect of the proximal phalanx. After manual realignment of the toe periosteal or intraosseous fixation of the tendon. POSTOPERATIVE MANAGEMENT:Bulky dressing with well-aligned toes. Anti-inflammatory drugs. Walking (full weight bearing) with a forefoot relief orthosis for 4 weeks. Toe splint and/or bandage for 12 weeks. Active exercises (toe flexion, standing on tiptoes, aquajogging) can be started after 4 weeks. Comfortable shoeware after 4 weeks. RESULTS:23 of 32 patients with flexible medial malalignment of the lesser toes II and/or III were followed up after a mean of 19 months. Medial malalignment could be reduced markedly (preoperatively 28 degrees, postoperatively 6 degrees). Four patients treated with the tendon transfer alone developed a recurrent deformity with dorsal subluxation at the metatarsophalangeal joint level. These patients revealed a concomitant hallux valgus deformity of >30 degrees. Six patients with an additional metatarsal shortening presented with floating toes. Although all patients were able to stand on tiptoes, the active range of toe motion was decreased. Radiologically, joint congruency was improved. 18 patients revealed a congruent joint, and five patients presented with a medial subluxation of the proximal phalanx.
journal_name
Oper Orthop Traumatoljournal_title
Operative Orthopadie und Traumatologieauthors
Fuhrmann RAdoi
10.1007/s00064-009-1608-8subject
Has Abstractpub_date
2009-03-01 00:00:00pages
88-96issue
1eissn
0934-6694issn
1439-0981journal_volume
21pub_type
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journal_title:Operative Orthopadie und Traumatologie
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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abstract::Erratum to: Oper Orthop Traumatol 2017 https://doi.org/10.1007/s00064-017-0513-9 The article was wrongly published under the article type "Review". Please note that the article is an "Original Paper".The publisher apologizes to the authors and …. ...
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pub_type: 已发布勘误
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更新日期:2018-02-01 00:00:00
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更新日期:2006-09-01 00:00:00
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更新日期:2012-07-01 00:00:00
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更新日期:2013-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2015-06-01 00:00:00
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更新日期:2013-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-10-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2014-08-01 00:00:00
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更新日期:2012-02-01 00:00:00
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更新日期:2008-06-01 00:00:00
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更新日期:2010-11-01 00:00:00
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更新日期:2015-06-01 00:00:00
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更新日期:2013-04-01 00:00:00
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更新日期:2014-12-01 00:00:00
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更新日期:2013-08-01 00:00:00
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更新日期:2014-12-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2012-11-01 00:00:00
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更新日期:2014-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-12-01 00:00:00