OBJECTIVETo investigate difference between the appearance and the bony structure in the polysyndactyly of the fifth toe fused with the fourth toe.

METHODSFrom Jan. 2009 to Jan. 2014, 54 patients (65 feet) with polysyndactyly of the fifth toe fused with the fourth toe were treated. The appearance, X-ray and intraoperative finding were recorded and compared to classify the deformity. Then the extra toe was excised and syndactyly was separated. The malalignment and brachydactyly of the sixth toes were corrected simultaneously.

RESULTSAccording to the bone and joint type, the fifth toes were neoplastic toes without joints in 17 feet, or had poor bony and joint alignment with the sixth toes in 48 feet. So the fifth toes were excised in all the cases. The patients were followed up for 1 month to 4 years. The oblique deformity of sixth toes were corrected completely with improved length.

CONCLUSIONSThe polysyndactyly of the fifth toe fused with the fourth toe should be classified to design the excised toe (usually fifth toe) and correction procedure. The appearance and bony joint recovery are both important.

Humans ; Polydactyly ; pathology ; surgery ; Syndactyly ; pathology ; surgery ; Toe Phalanges ; abnormalities ; surgery ; Toes ; abnormalities ; surgery

Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe.
Adult ; *Fibroma ; *Glomus Tumor ; Humans ; Male ; *Osteochondroma ; *Toes/pathology/surgery

Multicentric reticulohistiocytosis (MRH) is a rare systemic disease, which commonly manifests as muco-cutaneous papulonodules and inflammatory erosive polyarthropathy. In this research, we report the clinical manifestations and management of a rare case of MRH with destructive arthropathy of bilateral hip joints and arthritis mutilans presenting with characteristic deformities. Disabling hip arthropathy that occurs secondary to MRH can be successfully managed with bilateral total hip arthroplasty (THA). Osteopenia and acetabular bone defects must be anticipated during THA. This case is reported due to its rare occurrence and because little literature has been published regarding THA in such patients.
*Arthroplasty, Replacement, Hip ; Fingers/pathology ; Hip/pathology/radiography/surgery ; *Histiocytosis, Non-Langerhans-Cell ; Humans ; Skin/pathology ; Toes/pathology

Actins ; metabolism ; Female ; Fibroma ; metabolism ; pathology ; surgery ; Foot Diseases ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Inclusion Bodies ; metabolism ; pathology ; Infant ; Toes

OBJECTIVETo study the methods and therapeutic effect of repairing deformity of nasal columella and tip by anastomosing its blood vessels with those of the great/second toe web flap.

METHODSThe donor site was the great/second toe web flap. Sewing the great/second toe web flap and nasal columella and tip together by using 5-0 silk thread, anatomizing facial artery and facial vein for three centimeters long behind submaximal, protecting lower jaw branch of facial nerve, separating a subcutaneous layer tunnel between nasal columella and one of facial artery and facial vein behind submaximal. Dorsal artery of foot, saphenous vein in the flap were anastomosed with the facial artery and facial vein behind submaximal through the tunnel under the subcutaneous layer.

RESULTSAll flaps survived, satisfactory therapeutic effect was obtained. Postoperative follow-up was 0.5-1 year. The reconstructed columella showed satisfactory contour, good texture and color, and good resistance to injury.

CONCLUSIONSGreat/second toe web flap is a ideal skin flap for repairing deformity of nasal columella and tip.

Adult ; Female ; Humans ; Male ; Middle Aged ; Nose ; pathology ; surgery ; Skin Transplantation ; Surgical Flaps ; Toes ; surgery ; Young Adult

Calcium-Binding Proteins ; metabolism ; Diagnosis, Differential ; Female ; Fibroma ; metabolism ; pathology ; surgery ; Humans ; Inclusion Bodies ; pathology ; Infant ; Microfilament Proteins ; metabolism ; Skin Neoplasms ; metabolism ; pathology ; surgery ; Soft Tissue Neoplasms ; pathology ; Tendons ; pathology ; Toes ; Vimentin ; metabolism

OBJECTIVETo explore clinical effect of minimally corrective osteotomy for the treatment of hallux valgus with deformity of little toe varus through small incision.

METHODSFrom January 2013 to June 2016, 168 hallux valgus patients with deformity of little toe varus were treated by minimally corrective osteotomy through small incision. Among them, 7 males and 161 females were aged from 22 to 75 years old with an average of(59.3±3.5) years old. Preoperative clinical manifestation mainly focus on red and swollen of bunion, pain around with metatarsal bones, and diagnosed as hallux valgus with deformity of little toe varus through small incision. Operative time, postoperative complications, pre and post-operative IMA(angle between the first and the second metatarsal bones), HVA (hallux valgus angle), LDA(valgus angle of the fifth metatarsal bones), MPA(valgus angle of little toe), IM4-5 (angle between the forth and the fifth metatarsal bones) and PASA(fixed angle of proximal joint), postoperative AOFAS score were used to evaluate foot function.

RESULTSOne hundred and sixty-eight patients were followed up for 6 to 48 months with an average of (28.6±3.2) months. All wounds were healed well without infection, sinus tract and other complications. Operative time ranged from 16 to 28 min with an average of (18.3±2.1) min. IMA, HVA, LDA, MPA and IM A 4-5 were (10.1±2.1)°, (32.6±4.2)°, (6.9±2.3)°, (18.5±5.2)°, (15.1±2.9)°preoperatively, improved to (8.3±2.2)°, (10.9±2.9)°, (2.7±0.4)°, (6.5±1.6)°, (8.9±1.8)° postoperatively, and had significant differences before and after operation. While there was no difference in PASA before (9.1±2.1)°and after operation(8.7±1.9)°. AOFAS score were improved from (31.6±3.9) before operation to(83.7±5.2) after operation, but no significant difference(>0.05). According to AOFAS score, 147 patients obtained excellent results, 13 good, 6 moderate and 2 poor.

CONCLUSIONSMinimally corrective osteotomy for the treatment of hallux valgus with deformity of little toe varus through small incision could obtain satisfied clinical effect, and has advantages of small incision, no stitches, beautiful appearance, shorter operation time, and rapid recovery. It is worth popularization in clinical practise.

Adult ; Aged ; Female ; Hallux Valgus ; surgery ; Humans ; Male ; Metatarsal Bones ; pathology ; Middle Aged ; Minimally Invasive Surgical Procedures ; Osteotomy ; methods ; Postoperative Period ; Radiography ; Toes ; pathology ; Treatment Outcome ; Young Adult

Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Fibrosarcoma ; metabolism ; pathology ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucocele ; metabolism ; pathology ; Myxoma ; metabolism ; pathology ; surgery ; Skin Neoplasms ; metabolism ; pathology ; surgery ; Toes ; Vimentin ; metabolism

OBJECTIVETo investigate the reconstruction of thumb II-III degree defect by big toe wrap-around flap combined with second toe proximal interphalangeal joint.

METHODSBetween May 2004 to July 2012, 25 cases with thumbs II-III degree defects were treated. The ipsilateral big toe wrap-around flap combined with second toe proximal interphalangeal joint was designed to reconstruct the thumb defects based on the thumb size on the healthy side. The distal end of hallux was covered by flap at tibial side. The wound at the fibula side was covered by skin graft and flap. The bone defect at the second toe was filled with remnant hallux or iliac bone.

RESULTSAll the 25 reconstructed thumbs survived completely. The patients were followed up for 6-26 months without any joint degeneration. According to the finger reconstruction functional criterion publicized by China Medical Association, the finger function was assessed as excellent in 10 case, good in 11 cases, poor in 4 cases. Joint necrosis happened in 2 cases and bone malunion in 2 cases. The 4 cases received dead bone debridement and iliac bone graft. No malfunction occurred in the donor site.

CONCLUSIONSOur surgical method is a currently effective way to reconstruct II-III degree thumb defects. Satisfactory functional and cosmetic results can be achieved both in donor site and recipient site.

Aged ; Bone Transplantation ; methods ; China ; Hallux ; Humans ; Ilium ; transplantation ; Necrosis ; etiology ; Postoperative Complications ; pathology ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Thumb ; surgery ; Toes

OBJECTIVETo analyse the vola stress change after operation of wrop-around flap for thumb reconstruction,to know the influence of vola pressure change after operation of wrop-around flap.

METHODSFrom 1996 to 2004, 23 patients after the operation of wrop-around flap for thumb reconstruction were measured the entire footprint, the vola stress of single foot and double feet on static state and walking status. There were 16 males and 7 females,with a mean age of 23.7 years (17 to 42 years). The time from operation to measuring was 1.6 to 6 years (meana 3.8 years). The results of measuring were analyzed.

RESULTSWhether static footprint analysis or dynamic mechanical analysis, the plantar pressure distribution of donated foot were obviously different with those of the opposite site. The weight bearing of heel and the fourth and fifth metatarsal heads were nearly consistent with normal foot. But the former feet were obviously different. The weight bearing of the first metatarsal head was obviously lower than normal foot. And the weight bearing of the second and third metatarsal heads were obviously higher than normal foot.

CONCLUSIONThe operation of wrop-around flap for thumb reconstruction has advantage of the cosmesis and function of the reconstructed thumbs nearly consistent with normal thumbs. But the operation influences the postoperative foot pressure.

Adolescent ; Adult ; Female ; Humans ; Male ; Posture ; Reconstructive Surgical Procedures ; methods ; Stress, Mechanical ; Surgical Flaps ; Toes ; pathology ; physiopathology ; surgery ; Weight-Bearing ; Young Adult