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DORSOMEDIAL APPROACH TO THE FIRST TOE AND METATARSOPHALANGEAL JOINT

USES

This approach is used for bunion procedures, osteotomies of the proximal phalanx of the first toe, and treatment of hallux rigidus.

ADVANTAGES

This is a direct approach onto the bones, which are subcutaneous. The approach is in the gap between the dorsum of the toe and the medial aspect of the toe, where shoes would put pressure on the area of the incision.

DISADVANTAGES

There are no major disadvantages to this approach.

STRUCTURES AT RISK

The only significant structures at risk are the sensory nerves, which typically are in the area of the incision. The toe extensor tendons are at risk if you drift too far in a lateral direction. The sensory nerves need to be identified and protected; otherwise, the patient may develop a painful neuroma when wearing shoes or sandals.

TECHNIQUE

Related posts:

Volar Approach to the Basal Joint of the Thumb (for Bennett’s Fracture) Anterior Approach to the Distal Thigh and Femur Anterolateral Approach to the Tibia Deltopectoral Approach Posterior Approach Anterior Approach to the Cervical Spine

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