[Amputation and exarticulation of the lesser toes].
OBJECTIVE
Amputations and exarticulations of the toes may be necessary due to several reasons. The goal is to remove necrosis or infection prior to its spread to the midfoot region. From a functional or cosmetic point of view, amputation/exarticulation of a single toe plays no major role. However, this can be different with exarticulation of several toes.


METHODS
Necrosis, trauma, infection, tumor, deformity.


METHODS
Conditions where amputation/exarticulation of a toe is insufficient, e. g., in progressing peripheral arterial disease.


METHODS
The toe can either be amputated through the distal phalanx or exarticulated in the metatarsophalangeal joint.


METHODS
Orthopedic shoes or orthotic devices are rarely necessary when a single toe is amputated/exarticulated. However, concomitant deformities of the foot have to be thoroughly addressed. If more than one toe is amputated, silicone spacers may be necessary to prevent the remaining toes from deviating.


RESULTS
Amputations and exarticulations of the toes are frequent and the procedure is technically simple. However, the complication rate is high due to typical indications making amputation necessary.
Zentrum für Ambulante Rehabilitation, Regensburg, Deutschland.
C
C
Roll
Abteilung für Orthopädie und Unfallchirurgie, Robert-Bosch-Krankenhaus, Auerbachstr. 110, Stuttgart, Deutschland.
M
M
Forray
Abteilung für Orthopädie und Unfallchirurgie, Robert-Bosch-Krankenhaus, Auerbachstr. 110, Stuttgart, Deutschland. bernd.kinner@rbk.de.
B
B
Kinner
D000671:Amputation, Surgical / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D017719:Diabetic Foot / Q000175:diagnosis* / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans; D013524:Surgical Flaps; D014034:Toes / Q000002:abnormalities* / Q000601:surgery*; D016896:Treatment Outcome
Amputation; Complications; Exarticulation; Toe