Abstract
Introduction: Lesser toe deformities which require surgery are often treated using a technique of interphalyngeal joint fusion. This procedure is an effective way of reducing the deformity and pain associated with lesser toe deformity but necessitates internal fixation until fusion is achieved. The Kirschner wire used to provide peri-operative stability is undesirable for a number of reasons, most importantly, the risk of interosseous infection and the lack of patient satisfaction due to the need for a second procedure for the wires removal. The ‘Oxford’ procedure was developed by the senior author (PHC) both in an attempt to remove the need for Kischner wire fixation and to maintain some mobility at the interphalyngeal joint.
Patients and methods: Between January and October 1994, 14 patients underwent ‘Oxford’ procedures on isolated lesser toe deformities. Their mean age was 59 at the time of surgery (range 26 – 79, 3 male and 11 female). Each patient was reviewed in November 1995 and an assessment was made of their post-operative pain levels, function, footwear, cosmetic appearance, time to return to work and any complications they had experienced. In March 2005 (ie: at least 10 years postop) an attempt was made to review these patients and make assessments of their pain in the operated toe, any subsequent surgery in that, or other toes, and the stability of the toe. In addition, an assessment was made of the patients view of the cosmetic outcome and their satisfaction levels. 12 patients were successfully contacted and reviewed.
Results: All 12 patients were satisfied with their long term results in terms of pain relief and cosmesis.
Conclusion: The ‘Oxford’ proceedure for lesser toe deformities has good long term clinical results and avoids k-wire fixation.
Correspondence should be addressed to the Honorary Secretary, BOFSS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
