Lesser toe deformities such as mallet toe, hammer toe and claw toe are annoying problems not only to patients but also to orthopaedic surgeons because they are not easy to manage or treat. Though they occupy very small portion in whole body, they are notorious for unpredictable surgical results. It can make clinical results better to understand these deformities more comprehensively and to make strategic surgical plan for each target deformity.
Congenital Abnormalities ; Hammer Toe Syndrome ; Humans ; Toes

We reviewed the clinical features of 2 patients who underwent surgery for subungal exostosis, focusing on postoperative deformity of the nail. The lesion destroyed the nail bed and was excised with a direct approach. then thin split-thickness sterile matrix graft was done after excision of the tumor because the defect of the nail bed was large. Good postoperative appearance of the nail was obtained by thin split-thickness sterile matrix graft. The use of thin split-thickness sterile matrix graft for the replacement of a nail bed defect can regain a smooth, adherent, and normal-looking nail and avoid donor-site morbidity. Thin split-thickness toe-nail bed graft is a good choice for the prevention of postoperative deformity.
Congenital Abnormalities ; Exostoses ; Humans ; Nails ; Toes ; Transplants

Infantile digital fibromatosis(IDF) is a rare, benign fibrous tumor, first described in 1965 by Reye. IDF may occur single or multiple lesions exclusively on the fingers or toes, rare occurrence outside the digit have been reported. This tumor grow slowly and may adhere to the deeper tissue, and may lead to deformity of the digit, but do not distant metastasis or dissemination. There is a marked tendency for recurrence after surgical excision. Up to now, only 6 cases have been reported in the literature showing spontaneous regression. We experienced a case of infantile digital fibromatosis located on hypothenar area at birth. Also that spontaneous regressed at 13 months of age. We reported a case of IDF showing spontaneous regression with brief review of related literature.
Congenital Abnormalities ; Fibroma* ; Fingers ; Neoplasm Metastasis ; Parturition ; Recurrence ; Toes

Congenital absence of nails usually occur as a rare isolated anomaly or combined with other ectodermal defects. This anomaly is regarded as an inherited disorder either dominantly or recessively but quite a few cases were reported as sporadically developed. The patient was a 2-month-old girl who had no nails on both her 2nd, 3rd toes but had rudimentary nails on her left big toe and both 4th toes at birth. We could not find any other congenital deformity, any family history of inherited diseases related to anonychia. Radiological findings revealed no visualization of both 4th distal phalanges, only. We report this case as congenital anonychia of a sporadic type which may have developed independently from an underlying bone abnormality. We also review other reported cases in the literature.
Congenital Abnormalities ; Ectoderm ; Female ; Hallux ; Humans ; Infant ; Parturition ; Toes*

Hallux valgus, or a 'bunion', is a deformity characterized by lateral deviation of the big toe. Surgery is indicated when conservative treatments have failed to result in improvement of symptoms. Operative techniques include simple bunionectomy, distal soft tissue procedure, phalangeal osteotomy, metatarsal osteotomy (distal, shaft, or proximal), arthrodesis (metatarsophalangeal or tarsometatarsal), or resection arthroplasty. Good results are expected when the selection of operative technique is based on the correct treatment principle.
Arthrodesis ; Arthroplasty ; Congenital Abnormalities ; Hallux Valgus* ; Metatarsal Bones ; Osteotomy ; Toes

BACKGROUND: A pincer nail is characterized by the presence of an excessively curved and distorted nail across the transverse dimension. A multitude of therapeutic modalities have been implemented to treat this condition with limited efficacy. OBJECTIVE: We sought to evaluate the efficacy of surgery for pincer nail deformity with the use of the nail bed flap and bilateral partial matrixectomy, with or without osteophyte removal. METHODS: Nine patients (four patients: both great toe nails, five patients: single toe nail) with pincer nail deformities were treated with nail bed flap and bilateral partial matrixectomy, with or without osteophyte removal. Objective assessment was evaluated by use of the width index (width of the nail tip/width of the nail root) and height index (height of the nail tip/width of the nail tip). Subjective assessment was evaluated through patient global assessment (PGA) and use of the pain visual analogue scale as declared by patients. In addition, wound complications and recurrences were described. RESULTS: The width index and height index were improved (width index: 85.5%-->97%, height index: 54.3%-->3.4%). All of the patients claimed 'good' or higher in the PGA score. Relief of pain was shown in 100% of the cases. There was no recurrence during a 6- to 20-month period (mean time: 11.8 months) and no complications. CONCLUSION: Nail bed flap and bilateral partial matrixectomy with or without osteophyte removal as a surgical approach might be an effective and curative method of treatment for pincer nail deformity.
Congenital Abnormalities ; Humans ; Osteophyte* ; Recurrence ; Toes ; Wounds and Injuries

Bart's syndrome was initially described as a genodermatosis characterized by congenital localized absence of the skin with blistering and nail deformities 1-3. However, it is considered as any type of epidermolysis bullosa(EB) with localized congenital absence of the skin on the extremities. A 33-day-old fbmale baby was presented with congenital absence of the skin over the left shin and dorsa of both feet which were covered with the thin, translucent, and brown-red glistening membranes. Blistering of the right calf and left great toe nail deformity were also noted. She was diagnosed as a recessive dystrophic EB by the histopathological, ultra- structural and immunomapping studies.
Blister ; Congenital Abnormalities ; Extremities ; Foot ; Membranes ; Skin ; Toes

PURPOSE: To analyze treatment outcome of curly toe and to suggest appropriate treatment modality according to the degree of deformity. MATERIALS AND METHODS: 26 patients with 37 curly toes were subject to study. The mean age was 20 months (range 6 to 42 months), and one neglected case aged 28 years. Grade 1 were treated with strapping. Grade 2 and 3 were treated with open flexor tenotomy. The degree of deformity was analyzed by utilizing grade which Hamer and others once used previously, and the condition of pre- and post-treatment was evaluated. RESULTS: Of 18 cases with preoperative condition grade 1, all cases had favourable results which showed 16 cases remaining in grade 1 and 2 cases becoming almost normal. The average grade was 0.88 at the last follow-up. Of 19 cases with preoperative condition grade 2 or grade 3, 5 cases had remained mild rotational deformity with grade 1, and 14 cases were recovered to normal. The average grade was 2.57 preoperatively and 0.26 postoperatively. CONCLUSIONS: It is very important to assess the degree of deformity before deciding treatment method for curly toe. In case of grade 2 or grade 3, an open flexor tenotomy has proven to be effective treatment. Surgical treatment may provide favorable results regardless of age, whenever it is performed in case with persistent severe deformity.
Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Tenotomy ; Toes* ; Treatment Outcome

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

The camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP) is characterized by congenital or early-onset camptodactyly, childhood-onset noninflammatory arthropathy associated with synovial hyperplasia. Some patients have pro-gressive coxa vara deformity and/or noninflammatory pericardial effusion. CACP is inherited as an autosomal recessive mode and the disease gene is assigned to a 1.9-cM interval on human chromosome 1q25-31. We describe a 10-yr-old boy who has typical features of CACP without familial association.
Adolescent ; Fingers/*abnormalities ; Hip Joint/*abnormalities ; Humans ; Joint Diseases/*congenital/*diagnosis ; Male ; Pericarditis/*congenital/*diagnosis ; Syndrome ; Toes/*abnormalities