Effect on balance and gait secondary to removal of the second toe for digital reconstruction: 5-year follow-up

J Pediatr Orthop. 2003 Jan-Feb;23(1):60-4.


Foot anatomy and lower limb function were analyzed in 11 children (aged 6.5-12.5 y) 5 years after removal of one or two second toes for digital reconstruction. In addition to physical examination and x-rays, postural balance and three-dimensional measurements of gait were analyzed. Among the 15 operated feet, five had bridle scars, three had claw deformities of the third toe, five had pain in the first intermetatarsal space, and seven had overt or early-stage hallux valgus (including five after unilateral toe removal). Hallux valgus deformation was also observed in three nonoperated feet. Maintenance of balance and rate of displacement of the center of pressure when standing on one foot with eyes closed were significantly altered for operated limbs compared with nonoperated limbs. Gait was rapid because of increased step cadence. Foot progression angle and ankle and knee joint sagittal kinematics during walking were normal. Although children appeared to not be affected in their daily life by the removal of the second toe(s), related foot anatomic and functional modifications require further follow-up.

Publication types

  • Comparative Study

MeSH terms

  • Amputation, Surgical / adverse effects*
  • Bone Transplantation
  • Child
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Foot Deformities, Acquired / diagnostic imaging
  • Foot Deformities, Acquired / etiology*
  • Gait / physiology*
  • Hallux Valgus / diagnostic imaging
  • Hallux Valgus / physiopathology
  • Hand Deformities, Congenital / diagnostic imaging
  • Hand Deformities, Congenital / surgery*
  • Humans
  • Male
  • Plastic Surgery Procedures / methods
  • Postural Balance / physiology*
  • Probability
  • Prospective Studies
  • Radiography
  • Risk Assessment
  • Sensation Disorders / etiology*
  • Sensation Disorders / physiopathology
  • Toes / surgery*
  • Toes / transplantation
  • Treatment Outcome