Abstract
Aim: To assess the T-L plasty as a treatment of the overriding fifth toe.
Materials and Methods: 12 cases of T-L plasty undertaken for an overriding fifth toe were reviewed ( Mean age 9.8 years). The operation entails a T-shaped dorsal and plantar incision over the fourth to fifth web space. Extensive tenotomy and dorsal capsulotomy of the little metatarsophalangeal joint is undertaken. The corner of the lateral dorsal flap is advanced along the longitudinal limb of the ‘T’ and the incision is converted to an L-shaped wound. This transposition is reversed in the plantar aspect. The correction is stable without the need for K-wire fixation.
Results: 11 patients were satisfied with the correction. In 4 of the cases, the external rotation of the overriding fifth toe was not corrected. There was one failure. However, he had previously had 2 Butler procedures. The scar was acceptable.
Conclusion: The Freund is an alternative method for correction of an overriding fifth toe.
The abstracts were prepared by the Editorial Secretary Robin W Paton. Correspondence should be addressed to him c/o BOA, 35–43 Lincoln’s Inn Field, London WC2A 3PN.
