Repair of Overlapping Toes

Overlapping Toes:

- involves an dorsal-adduction deformity of the 5th toe;
- other components of the deformity include external rotation of the digit, contracture of the EDL tendon;
- in some cases there may be dislocation of the MTP joint;
- often the deformity is familial and bilateral.

Clinical findings:

- the deformity is asymptomatic, but it can cause difficulty with shoe wear and pain over the dorsum of the toe;
- a dorsal callus is commonl;
- in some cases, there will be an associated bunionette.

DuVries Correction:

- may use lateral incision from osteotomy or may make second incision in 4th interspace;
- release the EDL, dorsal joint capsule, and medial collateral ligament.

Butler's Surgical Correction:

- create a dorsal racket incision over the little digit, centered over the EDL tendon;
- this allow the toe to be derotated;
- a second "handle" incision is made on the plantar aspect of the original wound, which is brought laterally and proximally;
- this incision allows the toe can now be moved laterally and plantarly;
- release the contracted extensor tendon and the dorsal capsule;
- in some cases, the plantar capsule will have to be released thru the dorsal capsule;
- for a good surgical result, the toe must passively lie in a corrected position;
- forced correction may place tension on the digital vessels;
- if residual deformity is present, more capsule needs to be excised;
- skin sutures can help keep the toe in a derotated position.

Of course no two people are the same. We would be happy to discuss your unique foot condition. You can always reach us:

1. Call and talk to a Doctor
2. Send your concerns and questions to us via E-mail
3. Arrange for a in-office consultation.