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Quintus superductus

Definition

This is a deformity, often already present at birth, in which a partial dislocation in the metatarsophalangeal joint of the little toe occurs. The fifth toe seems to be moved proximally and dorsally, and is often located with a rotating movement over the base of the fourth toe.

Causes

There seems to be no preference for male or female. This “malformation” occurs in 3O% of the cases in both feet, sometimes with a familial tendency.

Symptoms

Besides aesthetic complaints, patients experience little burden of this “quintus supradductus”, and rarely, a surgical procedure is necessary. Yet, in some cases, we see that pain occurs in adults as a result of friction between the toe and the shoe, whether or not in the presence of a corn. Since the extensor tendon of the little toe is almost always shortened, it should at least be lengthened or transferred during any possible operation.

Treatment

In case of persistent pain, despite the change of footwear, an operation can be proposed in which, minimally, the extensor tendon is lengthened and the dorsal and medial capsule is removed. From time tot time, a skin grafting should be done, an interphalangeal arthroplasty be performed and/or the extensor tendon be cut out.

Postoperative policy

After the operation, which takes place in day hospital, you can lean immediately, provided you are wearing adjusted footwear during 3 to 4 weeks. A taping during approximately 3 months can help avoiding a possible recurrence.