title: Effect on balance and gait secondary to removal of the second toe for digital reconstruction: 5-year follow-up.
abstract: Foot anatomy and lower limb function were analyzed in 11 children (aged 6.5-12.5 y) 5 years after removal of one or two second toes for digital reconstruction. In addition to physical examination and x-rays, postural balance and three-dimensional measurements of gait were analyzed. Among the 15 operated feet, five had bridle scars, three had claw deformities of the third toe, five had pain in the first intermetatarsal space, and seven had overt or early-stage hallux valgus (including five after unilateral toe removal). Hallux valgus deformation was also observed in three nonoperated feet. Maintenance of balance and rate of displacement of the center of pressure when standing on one foot with eyes closed were significantly altered for operated limbs compared with nonoperated limbs. Gait was rapid because of increased step cadence. Foot progression angle and ankle and knee joint sagittal kinematics during walking were normal. Although children appeared to not be affected in their daily life by the removal of the second toe(s), related foot anatomic and functional modifications require further follow-up.
authors.affiliation: Institut Régional de Réadaptation Nancy, CHU de Nancy, France. c.beyaert@chu-nancy.fr
authors.forename: Christian
authors.initials: C
authors.lastname: Beyaert
authors.forename: Sylvie
authors.initials: S
authors.lastname: Henry
authors.forename: Gilles
authors.initials: G
authors.lastname: Dautel
authors.forename: Noël
authors.initials: N
authors.lastname: Martinet
authors.forename: Françoise
authors.initials: F
authors.lastname: Beltramo
authors.forename: Pierre
authors.initials: P
authors.lastname: Lascombes
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: André
mesh_terms: D000671:Amputation, Surgical / Q000009:adverse effects*; D016025:Bone Transplantation; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology*; D005684:Gait / Q000502:physiology*; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000503:physiopathology; D006228:Hand Deformities, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D011336:Probability; D011446:Prospective Studies; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods; D018570:Risk Assessment; D012678:Sensation Disorders / Q000209:etiology* / Q000503:physiopathology; D014034:Toes / Q000601:surgery* / Q000637:transplantation; D016896:Treatment Outcome