Correction of crossover deformity of second toe by combined plantar plate tenodesis and extensor digitorum brevis transfer: a minimally invasive approach.

PURPOSE: To study the efficacy and safety of the combined plantar plate tenodesis and extensor digitorum brevis transfer in correction of claw toe deformity.

METHODS: Between 2007 and 2008, 11 patients (13 feet) underwent combined plantar plate tenodesis and EDB transfer for the correction of crossover second toe deformity. The clinical and radiological results were studied.

RESULTS: There was no more crossover toe deformity in all patients. Two patients had residual mild residual claw toe deformity. The lateral metatarsophalangeal angle in preoperative weight-bearing radiograph averaged 53° ± 5°. The postoperative lateral metatarsophalangeal angle averaged 23° ± 6°. The dorsoplantar metatarsophalangeal angle in preoperative weight-bearing radiograph averaged -9° ± 4°. The postoperative dorsoplantar metatarsophalangeal angle averaged 2° ± 4°.

CONCLUSIONS: Combined plantar plate tenodesis and extensor digitorum brevis transfer is an effective procedure to correct crossover second toe deformity. This is a relatively simple procedure and can be preformed through small incisions with minimal soft tissue dissection.

LEVEL OF EVIDENCE: Level 3 therapeutic study.