An individualized approach to surgical reconstruction for lateral polydactyly of the foot with an emphasis on collateral ligament reconstruction.

BACKGROUND

Most previous studies concerning the treatment of polydactyly of the foot have focused on surgical techniques for aesthetic improvement rather than functional alignment of the reconstructed toe. The purpose of this study was to present the authors' surgical procedures for preventing postoperative malalignment of the reconstructed toe and evaluate whether those procedures were useful for the treatment of polydactyly of the foot.

METHODS

The study included 30 feet from 26 patients, four male and 22 female, with four bilateral cases. The average age of the patients at surgery was 20 months, and average duration of the postoperative follow-up was 32 months. The ligamentous stability of the toe joint was reconstructed using the collateral ligament/periosteal sleeve from the excised toe. The authors evaluated postoperative complications of the toe involving varus or valgus deformities, thickening of the reconstructed toe, pigmentation of the grafted skin, and scar formation.

RESULTS

No cases revealed any varus or valgus deformities, pigmentation of the grafted skin, functional disturbance, or pain in the reconstructed toe after surgery. Regarding postoperative complications, the authors observed visible thickening in eight toes and scar formation in three toes, although the parents' evaluation in each case was "very satisfied" or "satisfied."

CONCLUSION

The authors recommend reconstruction of the ligamentous stability of the toe joint using the collateral ligament/periosteal sleeve from the excised toe to prevent postoperative malalignment.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.