Treatment of Fixed Lesser Toe Deformity
Goals:
1. Reduce dorsal subluxation of MTP joint
2. Restore flexion power of lesser toe
3. Correct length and flexion contractures through PIP joint
Sequence of Release:
1. EDL
2. EDB
3. Dorsal capsule
Trick: Let EDL proximal to toes 2 to 4 retract.
Transfer EDL no. 5 to the peroneus tertius
Girdlestone-Taylor Procedure for Fixed Toe Deformities
Dorsal incision
Trick: EDL Z-plasty for exposure of PIP joint and extensor contracture release
Trick: PIP joint resection corrects deformity and adjusts length
Trick: Flex toe at PIP joint; pulling with towel clip provides stability
Locate FDL between FDB
FDL split along median raphe
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