Ainhum presenting to the accident and emergency department.

a painful 'sore' on the medial aspect of his left little toe over the preceding month but had pain in the toe intermittently for some years. At the time of presentation the toe was attached only by a piece of thick skin on the lateral side of the toe, good volume peripheral pulses were present in the foot and sensation was normal (Fig. 1). He had no significant past medical history. Radiological examination of the foot revealed autolysis of the middle phalanx and head of the proximal phalanx of the little toe with preservation of the distal phalanx (Fig. 2). Appearances were characteristic of ainhum. The toe was amputated using local anaesthetic and the patient was given a course of antibiotics. The toe was redressed on two occasions and healed without complications.