Release notes of Foot – Phalanges

The content has been revised and extended by Khairul Faizi Mohammad (MY) and Brad Yoo (US), with Markku T Nousiainen (CA) and Richard E Buckley (CA) as executive editors.

Keen-Wai Chong (SG) helped to set up the table of content.

The Foot phalanges material, third edition, includes a detailed description of the following injury types and their management.

Distal hallux fractures:

• Nonoperative treatment
• K-wire fixation
• Amputation (excision)
• Nail bed excision
• Nail bed reconstruction
• ORIF – Lag screw

Diaphyseal and extraarticular end segment fractures of the proximal hallux:

• Nonoperative treatment
• K-wire fixation
• ORIF – Lag screw with or without neutralization plate
• ORIF – Plate

Partial articular fractures of the proximal hallux:

• Nonoperative treatment
• K-wire fixation
• Lag screw (with or without buttress plate)
• Amputation (excision)

Complete articular fractures of the proximal hallux:

• Nonoperative treatment
• K-wire fixation
• Fusion of MTP joint
• ORIF – Lag screws with or without plate
• ORIF – Plate fixation

Lesser toe fractures:

• Nonoperative treatment
• K-wire fixation
• Amputation (excision)
• Nail bed excision

MTP joint dislocation:

• Closed/open reduction with taping or rigid-soled shoe
• Closed/open reduction with K-wire fixation

Approaches:

• Medial approach to the hallux
• Dorsal approach to the proximal phalanx
• Dorsal approach to the first metatarsal phalangeal joint (MTPJ)

Patient preparations:

• Supine position with knee flexed 90°

Further reading:

• Patient examination
• References

The content was revised by Andrew Sands (US) and Christina Kabbash (US), with Richard E Buckley (CA) as executive editor.

Mandeep Dhillon gave feedback on the content. His comments and suggestions were considered and included.

The Foot phalanges material, second edition, included a detailed description of the following injury types and their management.

Hallux, proximal phalanx, diaphysis, simple:

• ORIF: screw fixation

Hallux, proximal phalanx, base, shear fracture:

• ORIF: screw fixation

Hallux, proximal phalanx, base, intraarticular T-type:

• ORIF: screws or plate

Hallux, proximal phalanx, base, intraarticular comminuted:

• ORIF or MTP joint fusion

Hallux, proximal phalanx, head, intraarticular:

• ORIF or K-wire fixation

Hallux, distal phalanx, base, impression fractures:

• Excision

2nd–5th row, MTP-joint dislocation:

• CRIF: K-wire fixation

2nd–5th row, proximal phalanx, head, small fragment:

• Nonoperative treatment

2nd–5th row, distal phalanx, multifragmentary fracture:

• Reinsertion of the nail

2nd–5th row, proximal phalanx, base, intraarticular T-type:

• K-wire fixation

2nd–5th row, proximal phalanx, head, intraarticular:

• K-wire fixation

2nd–5th row, proximal phalanx, excessively displaced:

• K-wire fixation

Approaches:

• Medial approach to the hallux
• Dorsal approach to 1st metatarsal and MTP joint
• Dorsal approach to the proximal phalanx

Further reading:

• Compartment syndrome

The first edition was created by Michael Castro ( US ), with Joseph Schatzker ( CA ) as executive editor .