Roll C, Forray M, Kinner B. [Amputation and
exarticulation of the lesser toes].
OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2016;
28:345-51. [PMID:
27259483 DOI:
10.1007/s00064-016-0451-y]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/10/2016] [Accepted: 03/11/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE
Amputations and exarticulations of the toes may be necessary due to several reasons. The goal is to remove necrosis or infection prior to its spread to the midfoot region. From a functional or cosmetic point of view, amputation/exarticulation of a single toe plays no major role. However, this can be different with exarticulation of several toes.
INDICATIONS
Necrosis, trauma, infection, tumor, deformity.
CONTRAINDICATIONS
Conditions where amputation/exarticulation of a toe is insufficient, e. g., in progressing peripheral arterial disease.
SURGICAL TECHNIQUE
The toe can either be amputated through the distal phalanx or exarticulated in the metatarsophalangeal joint.
POSTOPERATIVE MANAGEMENT
Orthopedic shoes or orthotic devices are rarely necessary when a single toe is amputated/exarticulated. However, concomitant deformities of the foot have to be thoroughly addressed. If more than one toe is amputated, silicone spacers may be necessary to prevent the remaining toes from deviating.
RESULTS
Amputations and exarticulations of the toes are frequent and the procedure is technically simple. However, the complication rate is high due to typical indications making amputation necessary.
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