Mallet Toe

Definition

 

Flexion deformity of DIPJ 

 

Aetiology

 

Usually in 2nd toe

- Long second MT

- Constrictive footwear

 

Clinical

 

Pain over

- tip of toe

- over dorsum of DIP joint

 

May be corn on tip of toe 

 

Fixed or flexible

 

Management

 

Non-operative

 

Shoes with roomy toe box

 

Operative

 

Surgical Algorithm

 

1.  Flexible

 

Percutaneous FDL tenotomy

 

2.  Fixed

 

A.  Excision arthroplasty of DIPJ  ± FDL release

 

B.  Arthrodesis 

 

C.  Terminal Symes amputation

 

3.  2nd MTPJ Dislocation

 

Reducible dislocation 

- Hammer toe repair

 

Reducible but unstable 

- FETTS + Hammer toe repair

 

Irreducible 

- E/O MT head + FETT + Hammer toe repair