23:T4f4,

Background: Flail toe is a bothersome complication following PIP resection arthroplasty, usually as a result of excessive bone resection. Patients complain of toe instability and catching on socks or shoes. We describe a PIP joint lengthening arthrodesis using structural bone graft for treatment of this condition. Materials and Methods: The results of 13 toe lengthening arthrodesis procedures in 13 patients were reviewed. Twelve patients were available for final followup, ranging from 6 to 70 (average, 31) months. Results: Relief of instability symptoms occurred in all of the patients. The union rate was 75% (9/12 toes). Infection occurred in four patients, all treated successfully with oral antibiotics and pin removal when necessary. Two patients presented with ischemic complications in the tip of the toe which resolved spontaneously with good final results. Eleven of 12 patients were satisfied with the procedure and stated that they would do the surgery again. Conclusion: We believe toe lengthening arthrodesis is a good salvage operation for a flail toe following PIP resection arthroplasty.

Level of Evidence: IV, Retrospective Case Series

24:T415,

A 70-year-old patient was referred for a surgical opinion with a flail digit. Flail digit occurs as a result of over resection to the head of the proximal phalanx beyond the surgical neck and proximally into the shaft. The patient was complaining of a symptomatic right fourth digit (pain 7/10 on a Visual Analogue Scale) that had previously undergone two failed hammer toe surgeries resulting in symptomatic plantar hyperkeratosis with no history of ulceration or infection. The patient was surgically managed with autologous bone graft harvested from an adjacent digit biphalangic phalanx. Six months postoperative, the patient presented asymptomatic. Anatomical alignment, digital stabilisation and function were achieved. Full autologous graft consolidation was confirmed radiographically. Favourable patient-reported outcomes using the Manchester–Oxford Foot Questionnaire showed improvement in all domains. Currently, there is no published case study or description utilising our surgical technique to treat flail digit deformity.

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Interphalangeal Joint Lengthening Arthrodesis for the Treatment of the Flail Toe

Phalangeal autologous bone graft for flail digit subluxation: A case report