Rotational Deformity of the Fifth Toe

Abstract

Several unique deformities can occur in the fifth toe, including overlapping, underlapping, and cock-up malpositions. Conservative treatment involves wearing shoes with higher and wider toe box areas. Toe caps and sleeves can also be used to relieve symptoms. Surgical treatment is determined by the severity of the deformity. For mild deformities, soft-tissue procedures such as VY-plasty and tendon transfers (Lapidus procedure, Zanoli procedure) may be recommended. For severe deformities, bone procedures (PIP joint arthroplasty, Ruiz-Mora procedure, partial phalangectomy) and soft-tissue procedures can be added to tendon transfers.

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