Butler Arthroplasty

Butler arthroplasty is used for surgical treatment of toe contracture or angular deformity. Congenital contracture, angular deformity or subluxation of the fifth toe is a more common familial malformation, but only half of them cause disability. The fifth phalanx external rotation and the metatarsophalangeal joint contracted to the dorsal side, so that the fifth toe overlaps the fourth toe, and the proximal interphalangeal joint often has some adduction; a few cases show that the fifth toe is flexed and collapsed inward. Below the 4th toe. The purpose of the surgery is to improve its appearance and function. The angle and extent of the fifth toe is determined by the surgical method. In most cases, soft tissue surgery (such as the fifth metatarsophalangeal arthroplasty) can be used for correction purposes. In some cases with particularly severe deformity, soft tissue correction and proximal phalange osteotomy or toe-toe can be used. Treatment of diseases: congenital multiple joint contracture Indication Butler arthroplasty is suitable for: Butler arthroplasty is suitable for congenital toe contracture or angular deformity, affecting its function or appearance. Preoperative preparation Preoperative radiographs of the foot X-ray should be taken to understand the changes and types of bone structure. Detailed examination of the shape and function of the sick child's foot, to determine the surgical plan. Surgical procedure Incision A double-handed racquet-like skin incision was made with the pedicle on the dorsal side extending proximally along the long extensor tendon of the toe, and the pedicle on the temporal side inclined outward to form an annular incision. 2. Correcting deformity Bluntly separating the flap, revealing the contracted toe extensor tendon, paying attention to protecting the neurovascular bundle, cutting the extensor tendon of the 5th toe, and separating the dorsal joint capsule of the toe (Fig. 12.27.7.1B). At this time, the fifth toe is partially rotated outward to the correct position. Due to prolonged standing, the temporal adhesion of the metatarsophalangeal joint capsule prevents the fifth toe from completely resetting the proximal and distal phalanges during rotation. If necessary, the adhesion of the temporal joint capsule can be bluntly separated, and then the switch capsule can be cut transversely so that the fifth toe is placed in a completely corrected position without any resistance. 3. Guanchuang Hemostasis, intermittent suture subcutaneous, skin. Aseptic dressing is applied.