Thank you to all that responded - v interesting. It is good to see the
careful consideration ,and patient selection that is taken on board before
choosing the procedure that will benefit the patient in short , medium, and
long term (by most at least)
David
> -----Original Message-----
> From: Stephanie Ainsley [SMTP:[log in to unmask]]
> Sent: Wednesday, March 17, 2004 10:49 PM
> To: [log in to unmask]
> Subject: Re: 2nd toe amputation
>
> 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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> >
>
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