Second Toe Deformity Correction

Abstract

Second toe metatarsophalangeal joint overload produces a spectrum of deformities, starting with metatarsalgia and synovitis, progressing to plantar plate and collateral ligament attenuation and rupture, leading finally to crossover toe deformity and joint subluxation and dislocation. Successful treatment of this problem requires careful preoperative assessment and selection of surgical techniques designed to address the individual biomechanical and anatomic factors contributing to the condition. This article presents an algorithm for sequential evaluation of the pathophysiology and a stepwise approach to the surgical correction of the deformity. Frequently, several procedures need to be combined to achieve a satisfactory outcome. The author's results showed improved patient satisfaction rate and fewer complications when combined techniques were used for the correction of difficult deformities over the use of a single procedure.