Definition
Flexion deformity PIPJ with
- MTPJ normal / simple
- MTPJ hyper-extended / complex
- DIPJ any position
- P1 may become subluxed or dislocated
Aetiology
Uncertain
Long second toe / MT
Hallux valgus
Tight shoes
Examination
Calluses
- dorsum of PIPJ
- beneath second MT head
Rigid v flexible
Correctable / Non correctable
Management
Non-operative
Extra depth or padded shoe, low heel
Operative
Concepts
- need to ensure enough room for corrected toe / shorten toe
- may need to treat HV as well
- may need to release flexor tendons if tight
1. Flexible Deformity
Girdlestone-Taylor FETT
2. Fixed PIPJ
A. DuVries Arthroplasty
B. Extensor tendon tenotomy + PIPJ fusion
C. Partial Proximal Phalangectomy
- leaves toe floppy
- poor cosmesis
- only as salvage
3. Fixed PIPJ and Subluxed MTPJ
Extensor Tendon Tenotomy + PIPJ fusion
+ Dorsal MTPJ capsulotomy
+ MT osteotomy
