Updated: 5/25/2015

Lesser Toe MTP Joint Approach

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https://upload.orthobullets.com/topic/12052/images/ed.jpg
https://upload.orthobullets.com/topic/12052/images/incise deep fascia.jpg
https://upload.orthobullets.com/topic/12052/images/expose joint capsule of mtpj.jpg
https://upload.orthobullets.com/topic/12052/images/retract joint capsule to expose joint.jpg
Indications
  • Excision of metacarpal heads
  • Distal metatarsal osteotomy
  • Partial proximal phalangectomy
  • Fusion of MTP joints
  • Capsulotomy of MTP joints
  • Tenotomy
  • Neurectomy
Positioning
  • Supine on operating table with a bolster under the thigh to flex the knee and keep the foot plantigrade on the table
Incision
  • Make 2-3cm dorsolateral incision parallel to corresponding extensor tendons  
  • If 2 adjacent joints need to be exposed, make the incision between them
Superficial Dissection
  • Incise the deep facia in line with the incision  
  • Retract the extensor tendon to reveal the MTP joint
Deep Dissection
  • Perform transverse or longitudinal arthrotomy  
  • Retract the joint capsule to expose the MTP joint  
 

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