The procedure is performed in the operating theatre under local anaesthesia, with a Penrose drain applied as a

tendon and joint capsule are identified overlying the proximal interphalangeal joint, (c) Removal of the head of the proximal phalanx with a double action bone cutting forceps, (d) Immediate postoperative appearance.

tourniquet at the base of the toe. No tourniquet is used if there is a question of vascular compromise. Two semi-elliptical incisions are made in a transverse manner over the distal interphalangeal joint of the toe. The incisions are carried down through the skin, the extensor tendon and joint capsule, and these structures are removed. The interphalangeal joint is identified and the collateral ligaments are severed using a Beaver No. 64 mini-blade. The blade is kept close to bone at all times. The distal aspect of the middle phalanx is transected with a power saw or with a bone-cutting forceps. It may be necessary to release the long flexor tendon, and this can be done through the same dorsal incision. The deformity is reduced and the dorsal capsule and skin are repaired in the usual fashion. In the absence of ulceration or infection, the corrected position of the toe is maintained by placing a 0.45 Kirschner wire across the joint in a retrograde manner, as described for hammer toe correction.

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