title: Operative Treatment for Fourth Curly Toe Deformity in Adults.
abstract: BACKGROUND
  Curly toe deformity, a relatively common condition, occurs because of contracture of the flexor digitorum longus and flexor digitorum brevis. Numerous operative techniques have been introduced for treatment. However, there are no reports on fixed, longstanding deformity in adults.
  
  
  METHODS
  Data on 32 toes in 24 consecutive patients treated from 2003 to 2013 who underwent dorsolateral closing wedge-shaped resection arthroplasty for fourth curly toe deformity with a minimum 1-year follow-up were reviewed retrospectively. The mean follow-up period was 49 months. All patients presented preoperatively with a fixed deformity, underriding the adjacent toe. Combined surgeries were performed in 17 cases.
  
  
  RESULTS
  Of 32 toes, fixed deformity presented more frequently at the proximal interphalangeal (PIP) joint, and resection at the PIP joint level was performed in 19 cases as opposed to 13 at the distal interphalangeal joint. The mean corrections of varus inclination and shortening were 31 ± 16 degrees and 3.1 ± 2.1 mm, respectively. American Orthopaedic Foot & Ankle Society scores significantly improved from 50 ± 2 preoperatively to 89 ± 8 at the final follow-up. There was 1 case of recurrence, floating toe deformity following pin tract infection in 1 case, and floating toe deformity without infection in 1 case.
  
  
  CONCLUSIONS
  We introduced dorsolateral closing wedge-shaped resection arthroplasty as a simple, effective, and powerful option for treating fixed, longstanding fourth curly toe deformity in adults.
  
  
  METHODS
  Level IV, retrospective case series.
authors: Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea.
authors: Jun Young
authors: JY
authors: Choi
authors: Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea.
authors: Hyun Joo
authors: HJ
authors: Park
authors: Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea sjs0506@paik.ac.kr.
authors: Jin Soo
authors: JS
authors: Suh
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D014033:Toe Joint / Q000601:surgery; D014034:Toes / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
keywords: forefoot disorders; outcome studies