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DISTAL PHALANGECTOMY FOR MALLET TOE



Abstract

Introduction

Mallet toe is a flexion deformity of the distal interphalangeal joint of the lesser toe. It causes pain and callosity in the toe tip and the dorsum of the distal interphalangeal joint. Campbell refers to the “terminal Syme’s amputation” for this condition but the results of this have not previously been reported.

Material and Methods

This is a retrospective review of 35 toes in 22 patients that underwent distal phalangectomy. Sixteen patients were aged over 70. Patients were interviewed by an independent observer regarding the pain relief, cosmetic acceptability and satisfaction with the procedure and were examined for callosity, stump tenderness, sensitivity and neuroma.

Results

All patients were satisfied including pain relief and cosmetic acceptability at an average follow up of 4.6 years. One patient had mild wound infection. One patient had asymptomatic nail growth. No stump tenderness, sensitivity or neuroma was noted.

Discussion and Conclusion

Coughlin reported a satisfaction rate of 89% and 86% following successful fusion and excision arthroplasty respectively. In this series all patients were satisfied. We feel that distal phalangectomy is an option in a selected group of elderly patients where pain relief and functional outcome is the priority.

The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.