What Is a Toenail Excision?

Polydactyl may be part of some genetic syndromes, but the most common is an independent deformity, which is an autosomal dominant inheritance, and its overall incidence is about 2 of surviving babies. The disease manifests as an increase in the number of toes, usually only one extra toe, but occasionally there may be multiple. The extra toe is mostly near the small toe or the toe, and the other three toes rarely have multiple toe deformities. Polyphasic deformities can be connected through the extremely thin soft tissues of the base, or osseous to the metatarsal bones or toes, or to the metatarsophalangeal joints, interphalangeal joints, or bifurcated polytoe deformities. Should refer to the structure and type of polyphasic deformity to determine the timing and method of surgery.

Multi-toe surgery

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Polydactyl may be part of some genetic syndromes, but most commonly exist as an independent malformation,

Multi-toe surgery

operation of polydactylia

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Multi-toe surgery is suitable for:

Congenital polytoe deformity affects aesthetics, wears shoes, and causes pain and dysfunction;

The timing of the operation is that the polyphasic deformities with extremely thin bases and only soft tissue connections should be surgically removed at any time after birth (including the neonatal period);

X-rays of the feet should be taken routinely before surgery to understand the changes and types of bone structure and develop a surgical plan;

The shape and function of the deformed toe should be checked in detail before surgery to decide the choice. The treatment of polytoe deformity is mainly to provide a satisfactory shape and suitable for wearing normal shoes. Generally, the extra toe that affects wearing shoes should be removed.

Basic anesthesia plus basic anesthesia, basic anesthesia, and general anesthesia were used. Supine position. An inflatable tourniquet was pierced near the affected thigh.

Polytoe deformity connected by soft tissue

A fusiform incision can be made on the pedicle of the deformed toe to remove multiple toes and suture the skin.

Polyphae deformity connected to metatarsophalangeal joint (or interphalangeal joint)

Make an elliptical or racket-shaped skin incision on the multi-toe base to be removed. Cut the skin and fascia, pull the toe tendon as far as possible and cut it off. Make a transverse incision and retain the joint capsule and ligament tissue attached to the extra toe, and cut off the metatarsophalangeal joint (or interphalangeal joint). Use a scalpel or scissors to sharply remove the flat part of the metatarsal head (or toe bone) that forms the articular surface with multiple toes. Repair the metatarsophalangeal (or interphalangeal) joint capsule and lateral collateral ligaments to maintain their stability. Suture the skin. If there is excess sacrum on the X-ray film, extend the incision to the back of the foot or the outside of the foot at the proximal end of the incision to remove the sacrum.

Polyphasic deformity with osseous bone (or phalanges)

Through the fusiform incision, the basal part of the multiple metatarsal bone (or phalanges) is exposed, bite out with a bite forceps, flatten, and suture the wound.

accompanied by deformity and shortening of the first metatarsal bone, correspondingly caused toe inversion

In this case, the extension of the abductor toe muscle, the overlap of the adductor muscle and the medial soft tissue must be done to restore the normal arrangement and prevent the recurrence of the deformity.

Forked Polydactyly

A wedge-shaped resection of the middle part of the bifurcation, including the toenails and phalanges, can be performed, and then the phalanges are fixed together, and the toenails and skin are sutured.

After multi-toe surgery, do the following:

Simple multi-toe excision, the affected limb is raised appropriately after surgery, and the suture is removed 10 days after surgery;

Those who have undergone tendon, joint capsule, and bone repair surgery should be fixed with a plaster cast for 3 to 4 weeks after surgery.