Lesser-Toe Abnormalities by Michael J. Coughlin J Bone Joint Surg Am Volume 84(8):1446-1469 August 1, 2002 ©2002 by The Journal of Bone and Joint Surgery,

Lesser-Toe Abnormalities

by Michael J. Coughlin

J Bone Joint Surg AmVolume 84(8):1446-1469

August 1, 2002

©2002 by The Journal of Bone and Joint Surgery, Inc.

Constricting shoe wear may lead to pressure and deformity of the lesser toes.

Michael J. Coughlin J Bone Joint Surg Am 2002;84:1446-1469


Various methods of conservative treatment: a soft pad for treatment of a corn on the fifth toe, a toe cap for treatment of a lesion on the tip of the toe, and tube gauze for treatment of a severe

hammer-toe deformity.



Mallet-toe deformities of the third, fourth, and fifth toes.



A toe crest may be used to diminish pressure and to assist with healing of the lesion at the tip of the toe.



Figs. 5-A through 5-F Technique for mallet-toe repair.



Fig. 6-A A simple hammer-toe deformity with contracture of the proximal interphalangeal joint and no deformity of the metatarsophalangeal joint.



Moderate hallux valgus deformity with a concomitant second hammer toe.



Figs. 8-A through 8-F Technique for repair of a fixed hammer toe.



Fig. 9-A Radiograph of preoperative hammer-toe deformity.



Figs. 10-A through 10-D Technique for repair of a flexible hammer toe.



Figs. 11-A and 11-B Instability following excessive bone resection.



Postoperatively molding may occur as the digit conforms to the space between the remaining digits.



Fig. 13-A Radiographic evidence of malalignment of the second toe following hammer-toe repair.



Clawing of all five digits demonstrated with the push-up test, in which the examiner's hand pushes the foot and ankle into dorsiflexion, causing clawing of the digits.



Figs. 15-A and 15-B The drawer test.



Figs. 16-A, 16-B, and 16-C Instability of the second metatarsophalangeal joint with progressive deviation.



End-on views showing mild deformity (top), moderate deformity (middle), and severe deformity (bottom).



Radiographs showing mild deformity (top), moderate deformity (middle), and severe deformity (bottom).



Figs. 17-A through 17-D Soft-tissue realignment for treatment of a crossover second toe.



Fig. 17-C Postoperative clinical appearance following flexor tendon transfer and soft-tissue realignment.



Figs. 18-A and 18-B Capital oblique osteotomy.



Figs. 19-A and 19-B Mini-syndactylization of the lesser toes.



The Mulder sign.



Cock-up deformity of the fifth toe.



Preoperative appearance of a crossover fifth-toe deformity.



Figs. 23-A through 23-D Technique for repair of an overlapping fifth toe.



Figs. 24-A through 24-E Technique of the Ruiz-Mora procedure.



Figs. 25-A through 25-F Technique of the Thompson procedure for treatment of an underlapping fifth toe.



Figs. 26-A, 26-B, and 26-C Syndactylization of the fifth toe.



Fig. 27-A Lateral fifth-toe corn.



Pad placed between the fourth and fifth toes to cushion an interdigital corn.



Figs. 29-A through 29-D Technique of partial condylectomy for treatment of a lateral fifth-toe corn.



Lesser-Toe Abnormalities by Michael J. Coughlin J Bone Joint Surg Am Volume 84(8):1446-1469 August 1, 2002 ©2002 by The Journal of Bone and Joint Surgery,

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