Amputation of the great toe.

Four patients who had undergone reimplantation of the great toe to create a thumb were studied. The follow-up period ranged from 29 to 62 months. In all cases, the great toe was disarticulated at the metatarsophalangeal joint. The patients felt their feet functioned at approximately 85% of normal, and none had any significant complaint of metatarsalgia. The one patient who participated in sports after the surgery noted that it was difficult to "push off" moving away from the involved foot. X-ray examination demonstrated retraction of the sesamoids, which accounted for the increased plantar flexion of the first metatarsal shaft. The second metatarsophalanageal joint drifted into varus an average of 8 degrees. The Harris mat demonstrated that there was an increase in weightbearing beneath the second and third metatarsal heads. It appears as though, on the basis of this study, the loss of the great toe in this manner does not significantly affect the normal everyday function of an individual's foot.