This year I was pleased to meet this young lady who was born with an extra toe on her left foot. In the scheme of things you could be forgiven for thinking this to be of little significance. To a young lady however the combined impact of a toe that catches on hosiery and hurts in shoes everyday it isn’t a minor problem. On top of that a desire to have a foot which looks similar to her friends and which doesn’t draw negative attention deserves our attention. The emotional impact of body image is personal and can be judged only by the individual in question.
In this case having established with the help of x-rays the degree of anatomical connection and the blood supply to each toe a plan to treat was made.
The x-ray confirms there is only a fibrous link between the fifth and extra digit. As a result of the two articulations with the 5th metatarsal the head of this bone has remodelled into an abnormal shape.
As is important when treating children the options were discussed fully with our patient and parent to ensure consensus for the treatment plan. The extra digit was removed.
Notice the wire used to ensure wound contracture post surgery did not result in any mail-alignment developing. This positional stability also helps secure new alignment of the toe bone over the metatarsal head For the first four weeks after surgery.
THE IMPACT
My work is not life-saving and certainly isn’t up there with heart surgeons or cancer specialists. Nonetheless it is rewarding and especially so when you have positively impacted on a young persons life. Thanks to my patient for permission to share her story and for following her postop instructions which helped achieve such a great result.
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