Proximal Phalanx Osteotomy in Percutaneous Correction of the Lesser Toe Deformities: A Cadaver Study

Abstract

Category:Lesser ToesIntroduction/Purpose:The correction of lesser toe deformities has been traditionally performed in an open fashion. With minimal-invasive foot surgeries becoming increasingly popular, correction of lesser toe deformities via percutaneous soft-tissue procedures and osteotomies is frequently performed. The aim of this study was to evaluate the site of percutaneous proximal phalanx osteotomy of the lesser toes in relation to the metatarsophalangeal joint line when performed without fluoroscopy guidance.Methods:In this experimental cadaver study, the metatarsophalangeal joints of the lesser toes of 20 cadaver samples (=80 toes) were palpated. A plantar skin stab incision was made just distal to the joint line without fluoroscopic control. Plantar closing osteotomies of the proximal phalanx were performed with a Shannon burr. Adorsoplantar view was taken with fluoroscopy. The location of the osteotomy and the relative distance from the metatarsophalangeal joint line was evaluated.Results:The majority (78/80; 97.5 %) of the osteotomies were localized in the metaphyseal region. No osteotomy violated the metatarsophalangeal joint.Conclusion:Percutaneous osteotomy of the proximal phalanx of the lesser toes guided by palpation without using the image intensifier is a safe procedure and does not violate the metatarsophalangeal joint.