Minimal incision techniques for digital deformities.

We have presented basic minimal incision approaches to the more common digital deformities. We feel that with proper evaluation of the deformity and the patient, minimal incision surgery techniques give excellent long-term results with several advantages. These advantages include: Less discomfort due to less surgical dissection. Less need for internal fixation by careful use of compression dressings in the immediate postoperative period along with early ambulation. Less disability. Compression dressings allow immediate ambulation in normal footgear. In most instances, the patient is able to return to work sooner and with less discomfort. Better patient acceptance. Procedures may be performed under local anesthesia in the office environment and the patient may usually return to work in normal footgear within 1 to 3 days. Cost containment. Not all digital deformities may be addressed through a minimal incision approach. Internal fixation, multiple procedures with special postoperative shoes, syndactylisms, fusions, transpositional osteotomies, and skin plasties may be necessary in more severe conditions. However, it is equally important to point out that not all digital deformities must be approached in the "traditional" manner, employing large incisions with deep structure dissection, retraction, and visualization. It is up to the podiatric surgeon to develop his skills, and, after carefully evaluating the abnormality, the patient, and his goals, to perform the surgical procedure that will result in the best long-term results with the minimal amount of discomfort, disability, and cost to the patient.