Riegger Martin, Guidi Marco, Filardo Giuseppe, Candrian Christian
Department of Orthopedic and Trauma Surgery, Ospedale S. Giovanni di Bellinzona e valli, Ospedale Regionale di Lugano, Via Ospedale, CH-6500 Bellinzona, Switzerland.
Department of Plastic Surgery and Hand Surgery, Universitätsspital Zürich, Rämistrasse 100, Zürich, CH 8091, Switzerland.
Case Rep Orthop. 2020 Nov 19;2020:8830166. doi: 10.1155/2020/8830166. eCollection 2020.
"Splay toe" is a rare deformity of the forefoot and often causes the occurrence of metatarsalgia and dysfunction while walking or weight bearing. Since it involves a deviation in the sagittal and transversal planes, often combined with a malrotation, surgical correction can be challenging. We describe a case of splay toe deformity in the forefoot causing metatarsalgia in a 62-year-old female patient with a former avascular osteonecrosis of the 2 metatarsal head Smillie stage V of Freiberg-Köhler's disease causing a splay toe between the 2 and the 3 rays. There are only few reports in the literature, and a clear treatment strategy has not been defined, yet, although, it has been described that most of these patients are operated more than once. In the presented case, we performed a successful treatment by a combined surgical technique consisting in modified Weil's osteotomy and the transfer of the extensor brevis tendon. We sustain that for correction of a multiplanar deformity of lesser toe deformities osseous correction as well as tendon transfer lead to successful therapy.
“散开趾”是一种罕见的前足畸形，在行走或负重时常常导致跖痛症的发生及功能障碍。由于它涉及矢状面和横断面的偏差，且常伴有旋转不良，手术矫正颇具挑战性。我们描述了一例62岁女性患者前足散开趾畸形导致跖痛症的病例，该患者既往有第二跖骨头缺血性骨坏死，处于弗赖贝格 - 克勒病的斯米利V期，致使第二和第三跖骨间出现散开趾。文献中仅有少数报道，且尚未明确一种清晰的治疗策略，尽管已描述大多数此类患者需接受不止一次手术。在本病例中，我们通过一种联合手术技术成功施治，该技术包括改良的韦尔截骨术和短伸肌腱转移术。我们认为，对于矫正小趾畸形的多平面畸形，骨矫正以及肌腱转移可带来成功的治疗效果。
