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Journal of the American Podiatric Medical Association
Volume 93 Number 3 167-173 2003
Copyright © 2003 American Podiatric Medical Association

Autogenous Bone Graft Interpositional Arthrodesis for the Correction of Flail Toe

A Retrospective Analysis of 22 Procedures

Kieran T. Mahan, MS, DPM*, Michael S. Downey, DPM{dagger} and Glenn D. Weinfeld, DPM{ddagger}

* Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA; The Podiatry Institute, Tucker, GA.
{dagger} Division of Podiatric Surgery, Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia.
{ddagger} Podiatric Surgical Residency Program, St Vincent Charity Hospital, Cleveland, OH.

Corresponding author: Kieran T. Mahan, MS, DPM, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Eighth at Race St, Philadelphia, PA 19107.

Abstract

Digital surgery is one of the most common types of surgery performed by foot and ankle surgeons. Flail toe is a complication that may occur after overaggressive resection arthroplasty of the proximal interphalangeal joint of the lesser toes. Correction of flail toe deformity has received little attention and has predominantly involved soft-tissue procedures. The authors’ preferred technique for the surgical correction of flail toe is to place a unicortical autogenous bone graft (harvested from the ipsilateral calcaneus) within the revised proximal interphalangeal joint of the lesser toes to create a distraction arthrodesis. This technique allows restoration of digital length, stability, and purchase. A retrospective review of 22 such procedures in 13 patients is presented, along with a literature review of other procedures and a description of the authors’ current surgical technique and postoperative management protocol. Overall success using the authors’ procedure was 82%. Complications occurred in three patients, with one of the grafts showing complete resorption and two requiring additional surgical intervention owing to nonunion and malunion of toes. (J Am Podiatr Med Assoc 93(3): 167-173, 2003)






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Copyright © 2003 by the American Podiatric Medical Association.