engleski

Treatment of toe and metatarsal deformities in children

Complex toe and metatarsal deformities in children encompass several types of pathology. By definition complex toe deformities are pre- axial (hallux duplex) and post-axial complex (bony fusion) polysyndactyly. Complex metatarsal deformities include longitudinal epiphyseal bracket (LEB) of the first metatarsal ; short fourth metatarsal, post-axial polymetatarsia (complete and incomplete), congenital synostosis of metatarsal bones and overgrowth syndromes e.g. macrodactyly, foot manifestation of Proteus syndrome. Radiographic staging of Mubarak et al. (JCO, 2013) is utilized as general guideline for treatment of LEB. According to patient’s age different approach is used. Short fourth metatarsal bone is deformity that occurs more often in females, with ratio female to male: 25:1. It is cosmetic deformity that is best treated by osteotomy and gradual distraction procedure with mini external fixator. This approach leads to less complications and satisfying cosmetic outcome for the patient. Polymetatarsia could be challenging when is accompanied with post-axial polydactyly due to difficulty which toe and metatarsal to amputate. Management approach of those complex toe and metatarsal deformities should be individualized. Author’s personal case series are serving to illustrate surgical approach and treatment outcomes.

Complex deformities ; toes ; metatarsal ; treatment

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