ABSTRACT
Lesser toe deformities such as mallet toe, hammer toe and claw toe are annoying problems not only to patients but also to orthopaedic surgeons because they are not easy to manage or treat. Though they occupy very small portion in whole body, they are notorious for unpredictable surgical results. It can make clinical results better to understand these deformities more comprehensively and to make strategic surgical plan for each target deformity.
Subject(s)
Humans , Congenital Abnormalities , Hammer Toe Syndrome , ToesABSTRACT
There are many different type of congenital toe anomalies such as syndactyly, polydactyly which are more common, and less frequently macrodactyly and curly toe. Congenital anomaly of hand can decrease the hand function and easy to be visualized, so the early treatment of anomaly is natural and recommended. On the other hand, Congenital anomaly of foot rarely decrease the foot function and was hidden in the shoe, so treatment of anomaly was delayed frequently. However, the surgery can be needed, as the foot getting grown-up, discomfort of shoe fitting or intractable plantar keratosis due to secondary deformation of foot can occur. A distinct feature and surgical consideration was compared with congenital anomaly of hand and it should be taken into account in the treatment of adult toe anomalies.
Subject(s)
Adult , Humans , Fingers , Foot , Hand , Keratosis , Limb Deformities, Congenital , Polydactyly , Shoes , Syndactyly , ToesABSTRACT
PURPOSE: To analyze treatment outcome of curly toe and to suggest appropriate treatment modality according to the degree of deformity. MATERIALS AND METHODS: 26 patients with 37 curly toes were subject to study. The mean age was 20 months (range 6 to 42 months), and one neglected case aged 28 years. Grade 1 were treated with strapping. Grade 2 and 3 were treated with open flexor tenotomy. The degree of deformity was analyzed by utilizing grade which Hamer and others once used previously, and the condition of pre- and post-treatment was evaluated. RESULTS: Of 18 cases with preoperative condition grade 1, all cases had favourable results which showed 16 cases remaining in grade 1 and 2 cases becoming almost normal. The average grade was 0.88 at the last follow-up. Of 19 cases with preoperative condition grade 2 or grade 3, 5 cases had remained mild rotational deformity with grade 1, and 14 cases were recovered to normal. The average grade was 2.57 preoperatively and 0.26 postoperatively. CONCLUSIONS: It is very important to assess the degree of deformity before deciding treatment method for curly toe. In case of grade 2 or grade 3, an open flexor tenotomy has proven to be effective treatment. Surgical treatment may provide favorable results regardless of age, whenever it is performed in case with persistent severe deformity.