Z-type shortening osteotomy of the proximal phalanx: A novel and safe joint sparing intervention to shorten lesser toes with good short-term outcome.

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-06-18 DOI:10.1016/j.fas.2025.06.004

Philipp Friederichsen, Melissa Wilhelmi, Pascal Rippstein

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引用次数: 0

Abstract

Background: Overlength of the lesser toes can lead to pain at the distal toe end and painful hammer and claw deformities. Fusion or resection of proximal interphalangeal joints are commonly used to address overlength, while sacrificing joint mobility. A Z-type shortening osteotomy of the proximal phalanx (SOPP) was developed as a joint-sparing alternative.

Methods: We outline this novel technique and retrospectively analyzed preliminary data from 13 patients (including 9 women) with a mean age of 42 years who underwent Z-type SOPP. Patients rated their postoperative satisfaction and assessments of radiographs and complications were made up to 1-year post-SOPP.

Results: Of 29 toes in total, mean postoperative shortening was 6.4 mm (range, 4-11 mm) and all showed complete union at 1 year. All patients were satisfied with the surgery and only two reported limited joint mobility. There were no reports of infection and delayed wound healing.

Conclusion: Z-type SOPP appears to be an effective and safe joint sparing treatment for lesser toe overlength in the short term.

Level of evidence: Retrospective case series, Level IV.

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近端指骨z型短截骨术：一种新颖、安全的关节保留干预缩短小脚趾，短期效果良好。

背景：小脚趾过长可导致远端脚趾末端疼痛和痛苦的锤爪畸形。近端指间关节的融合或切除通常用于解决过长，同时牺牲关节的灵活性。采用z型近端指骨缩短截骨术（SOPP）作为关节保留替代方法。方法：我们概述了这种新技术，并回顾性分析了13例平均年龄42岁的z型SOPP患者（包括9名女性）的初步资料。患者对术后满意度进行评分，并在sopp后1年内对x线片和并发症进行评估。结果：29个脚趾术后平均缩短6.4 mm（范围4 ~ 11 mm）， 1年全部愈合。所有患者均对手术满意，仅有2例报告关节活动受限。没有感染和伤口愈合延迟的报告。结论：z型SOPP是一种短期内安全有效的小趾过长关节保留治疗方法。证据级别：回顾性病例系列，四级。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.