I have a patient who had a 2nd toe amputation to remove a hammer toe - she
now has hallux valgus which she didn't have before and I have to make a
silicone wedge to keep the toes apart!
Stephanie Ainsley
----- Original Message -----
From: "Houghton, David" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, March 17, 2004 3:42 PM
Subject: 2nd toe amputation
> Hello all
>
> I would appreciate you comments re 2nd toe amputation for hammer toe
> deformity.
>
> The reason that I ask is that a Podiatric Surgeon was showing me pre an
> post op pics of a total 2nd toe amputation, in an active patient, I don't
> know their age, but approx in their 60's. His justification was that
> amputation is a more straightforward procedure, which I don't doubt.
>
> My argument was that with a Hallux Valgus ( which there was in the pics) ,
> then the prox phalanx would provide a buttress to prevent lateral hallux
> deviation. Perhaps I am mistaken in this assumption, and there is still a
> place for this surgery.
>
> The only example that I can think of where this could possibly be the
> procedure of choice is in a patient who has limited mobility, and has a
> screaming hammer toe, and 1st met ostotomy with 2nd toe arthrodesis would
> be like using a sledgehammer to crack a nut.
>
> I have put these points to the Pod Surgeon, and he disagrees that any
> buttress effect is provided by the 2nd toe when dorsally displaced, and
> therefore will continue to do the procedure, even in active patients.
>
> I am not a Pod Surgeon, so would appreciate some guidance about 2nd toe
> procedures, and under which circumstances they are indicated.
>
> David Houghton
>
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