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BACKGROUND: In the literature, there is no consensus regarding the surgical management of postaxial polydactyly, and few cases of polymetatarsia with polydactyly have been reported. Treatment of the complete deformity will prevent further foot and gait disorders. OBJECTIVE: To identify literature relevant to the operative management of Y-shaped metatarsal with biphalangeal sixth toe and related skin and wound care to improve surgical treatment protocols from a clinical experience perspective. DATA SOURCES: The authors searched several electronic databases in December 2022 for articles related to postaxial polysyndactyly in the feet and polymetatarsia. Databases searched included PubMed, SciELO, ScienceDirect, Cochrane Database of Systematic Reviews, and Google Scholar gray literature. STUDY SELECTION: Two independent researchers conducted the searches and read the article titles and abstracts. Studies were included if they were narrative reviews, case studies, or observational studies; written in English or Spanish; and published between 2012 and 2022. Nonhuman studies were excluded. Studies that met the inclusion criteria were fully evaluated. Disagreements between reviewers were resolved by consensus, and when there was no consensus, a senior researcher was consulted. DATA EXTRACTION: The following data were extracted from the included studies using a standardized form: author and year of publication, study type, number of participants, sex, polydactyly location, polymetatarsia, type of polydactyly, participants’ history of hereditary associated diseases or malformations, treatment, removal criteria, and timing of surgery. DATA SYNTHESIS: Authors evaluated 11 studies of postaxial polydactyly that included a total of 153 participants (64 men, 89 women). They also document their clinical experience with a surgical technique used in cases of bilateral postaxial polydactyly of the foot with a Y-shaped metatarsal with biphalangeal sixth toe. CONCLUSIONS: Surgical corre

Objetivo: El objetivo principal de este trabajo es determinar la variación de movilidad pre y postquirúrgica del primer radio. Pacientes y métodos: El diseño corresponde a un estudio prospectivo de series de casos en pacientes sometidos a cirugía de hallux valgus. Se valoró en 13 pies la movilidad del primer radio con el medidor del primer radio, la flexo-extensión de la primera articulación metatarsofalángica, el ángulo de Clarke y el “Arch Index” en pedigrafías, los ángulos hallux valgus e intermetatarsal I-II en radiografías dorsoplantares en carga, y la postura general del pie mediante el “Foot Posture Index” antes y después de ser sometidos a cirugía de hallux valgus. Todo ello con un periodo de seguimiento de 6 meses. Resultados: El rango total de movilidad del primer radio pasó de 11.74 ± 1.88 mm a 6.72 ± 2.20 mm; y el de la primera articulación metatarsofalángica pasó de 79.62° ± 22.33° a 48.69° ± 18.69° tras la cirugía. Los ángulos radiográficos de hallux valgus y ángulo inter metatarsal disminuyeron una media de 19.07° ± 8.20° y 7.23° ± 2.97°, respectivamente. El ángulo de Clarke cambió de 41.31° ± 10.79° a 38.31° ± 11.00°. El “Arch Index” cambió de 0.24 ± 0.06 a 0.25 ± 0.05. Y el “Foot Posture Index” pasó de 6.70 ± 3.33 de media antes de la cirugía a 5.46 ± 3.86 tras la misma. Conclusión: En los participantes incluidos en este estudio se observó una disminución generalizada de todas las variables examinadas tras la cirugía, a excepción de los parámetros valorados en las pedigrafías, que no llegaron a presentar diferencias relevantes., Objectives: The main aim of this work is to determine the variation of first ray mobility before and after surgery. Patients and methods: The design corresponds to a prospective case series of patients operated of hallux valgus. A total of 13 feet have been included in this study. Measurements of the first ray mobility were obtained using the first ray mobility measurer. Furthermore, we assess the flexo-extension of the first metatarsophalangeal joint. The Clarke’s angle and the Arch Index were evalued on weightbearing footprints. The hallux valgus angle and intermetatarsal I-II angle were made on weightbearing dorsal-plantar projection radiographs. And finally, the general posture of the foot was quantified using the Foot Posture Index. All this with pre and post measurements of hallux valgus surgery and with a follow-up period of 6 months. Results: The total range of motion of the first ray decreased from 11.74 ± 1.88 mm to 6.72 ± 2.20 mm; and the range of motion of the first metatarsophalangeal joint underwent from 79.62° ± 22.33° to 48.69° ± 18.69° after surgery. The hallux valgus angle and inter metatarsal I-II angle decreased by a mean of 19.07° ± 8.20° and 7.23° ± 2.97°, respectively. The Clarke’s angle changed from 41.31° ± 10.79° to 38.31° ± 11.00°. The Arch Index changed from 0.24 ± 0.06 to 0.25 ± 0.05. And the Foot Posture Index went from 6.70 ± 3.33 before surgery to 5.46 ± 3.86 after it. Conclusion: In the participants included in this study, a generalized decrease was observed in all the examined variables after surgery, except for the parameters assessed in the pedigraphs, which did not present relevant differences.

There are various pathologies that involve the hallux, among which hallux valgus is the most common. When conservative treatment fails, it is necessary to resort to a surgical approach. The fixation elements for osteotomies in the hallux are usually composed of metallic materials; however, today, there are numerous resorbable materials that offer numerous advantages over conventional materials. In this article, the objective is to analyze the scientific evidence through the systematic analysis of the existing literature in relation to the effectiveness of resorbable versus non-resorbable osteosynthesis material in the surgical correction of hallux deformities and compare the complications as well as the patient satisfaction and quality of life between both fixation methods. A systematic review of the literature available in the PubMed, EMBASE, Web of Science and Scopus databases and 10 studies were included. The documents were chosen following the eligibility and exclusion criteria, including experimental and observational studies evaluated with the Jadad and Newcastle-Ottawa methodological quality scale, respectively. Data were extracted from valid studies for the review, and the variables functionality, pain, angular corrections, complications, satisfaction and quality of life were observed. In conclusion, there is limited scientific evidence regarding the effectiveness of resorbable versus non-resorbable osteosynthesis material in the surgical correction of hallux deformities. All observed variables are similar regardless of the surgical technique and osteosynthesis material used.

Objective To analyze the impact of the foot health and health behavior and the characteristics of outdoor footwear among minority ethnic groups. Design and measures A cross-sectional study design using the Foot Health Status Questionnaire: foot pain, foot function, shoe, general foot health, general health, physical activity, social capacity, and vigor. Outcomes included the self-reported type of outdoor footwear and clinical characteristics by sex were collected in 2019–2020. Sample A total of 78 Roma participants self-identified as members of this ethnic minority and 72 participants non-Roma were assessed (n = 150). Results The lower score values was recorded in the footwear and general foot health domains in Roma population. General population obtained higher scores in general health domains. The most common outdoor footwear types were running shoes and walking shoes in non-Roma population, versus flip flops and slippers in Roma population. Clinical characteristics did not show any statistically significant differences (p < .05). Conclusion Roma people wear flip flops and slippers and non-Roma people running shoes and walking shoes. These findings reveal cultural differences that make it easier for the Roma population to experience a greater burden of foot health problems. General foot health and foot pain dimensions show statistically significant differences among ethnicity.

INTRODUCCIÓN. La técnica de fenol – alcohol es la más realizada en el tratamiento quirúrgico de la onicocriptosis por su baja tasa de recurrencias, sin embargo, ninguna de sus modificaciones permite abarcar estadíos avanzados de la patología. Con el presente estudio se pretende mostrar una modificación de la Reconstrucción estética, como una técnica versátil que permite abarcar estadíos más avanzados de la patología, sin los principales inconvenientes de las técnicas incisionales y con una efectividad similar a la del fenol. OBJETIVOS. En el presente estudio se pretende demostrar científicamente que la técnica Reconstrucción estética modificada presenta un tiempo de cicatrización menor con una efectividad similar a la técnica fenol – alcohol. Como objetivos secundarios se comparará la influencia de ambas técnicas sobre el dolor, la inflamación, el sangrado, la tasa de infección y la satisfacción estética con el procedimiento. METODOLOGÍA. Se seleccionaron 50 pacientes (82 pies) a los que se le practicaron 164 matricectomías parciales en bordes ungueales que presentaban onicocriptosis en estadíos I y IIa según la clasificación de Mozena y Martínez Nova. Se ha realizado un estudio comparativo a simple ciego, de dos grupos paralelos, en el que cada sujeto se asignó aleatoriamente a cada uno de los grupos. RESULTADOS. La técnica de Reconstrucción estética modificada presenta un tiempo de cicatrización (8,2 ± 1,3) significativamente menor que la técnica de Fenol – Alcohol (21,0 ± 2,9) sin diferencias significativas en la efectividad. No se encontraron diferencias estadísticamente significativas entre las variables secundarias dolor, inflamación, sangrado e infección. La satisfacción estética con el procedimiento fue mayor para el grupo Reconstrucción Estética modificada. CONCLUSIONES. Los resultados de este trabajo permiten afirmar que la técnica de Reconstrucción estética modificada tiene una efectividad similar a la técnica Fenol – alcohol presentando un tiempo de cica

El fibroqueratoma es una lesión tumoral benigna del aparato ungueal. Se trata de una lesión adquirida que se desarrolla a partir de un collarete epidérmico queratósico que rodea su base. Son tumores cutáneos, de naturaleza benigna, asintomáticos, generalmente de pequeño tamaño, consistencia firme, encapsulados y con una capa superficial gris perlada. Tienen una etiología desconocida. Morfológicamente, aparecen como una neoformación de forma semiesférica recubierta completamente por piel normal sonrosada y, generalmente, son asintomáticos. Inusualmente, los podemos encontrar como lesiones multilobuladas o multirramificadas. El diagnóstico es fundamentalmente clínico, apoyado en el informe de anatomía patológica de la lesión tras su escisión quirúrgica. El presente artículo presenta un caso clínico de escisión quirúrgica de un fibroqueratoma mostrándolo como una buena alternativa de tratamiento que ofrece una solución definitiva, sencilla y sin complicaciones para el paciente., Fibrokeratoma is a benign tumor of the nail. It is an acquired injury that develops from a keratotic epidermal collar that surrounds its base. They are benign, asymptomatic skin tumors, generally small in size, firm in consistency, encapsulated and with a pearly gray surface layer. They have an unknown etiology. Morphologically, they appear as a hemispherical neoformation completely covered by normal skin and are generally asymptomatic. Unusually, we can find them as multi-lobed or multi-branched lesions. Its diagnosis is mainly clinical, supported by the pathological report of the lesion after its surgical excision. The present paper presents a clinical case of a surgical excision of a fibrokeratoma showing it as a good treatment alternative that offers a definitive, simple and uncomplicated solution for the patient.

Background: In the treatment of Onychocryptosis, chemical matricectomy with 88% phenol solution is one of the most common surgical procedures due to a recurrence rate of less than 5%, but it may produce a delay in healing time. The objective was to compare the healing time between phenol applications of 30 or 60 s. Methods: A comparative, prospective, parallel, randomized, and blinded clinical trial was registered with the European Clinical Trials Database. Twenty-seven patients (54 feet) with 108 affected nail folds were randomized and treated with chemical matricectomy with phenol. Each hallux was randomly assigned to one of two groups (60 vs. 30 s phenolization). Each patient and one investigator were blinded to the phenol application time in each foot. The outcome measurements were healing time, recurrence, pain, post-surgical bleeding, inflammation, and infection rate. Results: The 30 s application presents a shorter healing time (14.93 ± 2.81 days vs. 22.07 ± 3.16 days; p < 0.001) with a similar recurrence rate (p = 0.99). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences (p > 0.05). Conclusions: The 30 s phenol application time offers a shorter healing time than 60 s without affecting the effectiveness of the procedure, showing the same rate of complications., Onychocryptosis

Background: In onychocryptosis surgery, incisional and non-incisional matricectomy is indicated according to the stage. The chemical matricectomy with 88% phenol solution is the gold standard and a wedge resection is indicated for more advanced stages. The aesthetic reconstruction has the advantages of the incisional procedure without eponychium incisions and an effectiveness similar to the chemical matricectomy with phenol. Objective: To compare the recurrence and the healing time between the chemical matricectomy with phenol and the aesthetic reconstruction. Methods: A comparative, prospective, parallel, randomized, and one-blinded clinical trial was registered with the European Clinical Trials Database (EudraCT) with identification number 2019-001294-80. Thrity-four patients (56 feet) with 112 onychocryptosis were randomized in two groups. Thirty-six were treated with chemical matricectomy with phenol and 76 with aesthetic reconstruction. Each patient was blind to the surgical procedure assigned by the investigator. The primary outcome measurements were healing time and recurrence. The secondary outcome measurements were post-surgical bleeding, pain, inflammation, and infection rate. Results: The aesthetic reconstruction procedure presents a shorter healing time (8.2 ± 1.4 days vs. 21.3 ± 3.1 days; p < 0.001) with a similar recurrence rate (p = 0.98). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences (p > 0.05). Conclusions: The aesthetic reconstruction presents a shorter healing time, favoring the patients’ recuperation, with a recurrence similar to the chemical matricectomy with 88% phenol solution., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Background: In onychocryptosis surgery, incisional and non-incisional matricectomy is indicated according to the stage. The chemical matricectomy with 88% phenol solution is the gold standard and a wedge resection is indicated for more advanced stages. The aesthetic reconstruction has the advantages of the incisional procedure without eponychium incisions and an effectiveness similar to the chemical matricectomy with phenol. Objective: To compare the recurrence and the healing time between the chemical matricectomy with phenol and the aesthetic reconstruction. Methods: A comparative, prospective, parallel, randomized, and one-blinded clinical trial was registered with the European Clinical Trials Database (EudraCT) with identification number 2019-001294-80. Thrity-four patients (56 feet) with 112 onychocryptosis were randomized in two groups. Thirty-six were treated with chemical matricectomy with phenol and 76 with aesthetic reconstruction. Each patient was blind to the surgical procedure assigned by the investigator. The primary outcome measurements were healing time and recurrence. The secondary outcome measurements were post-surgical bleeding, pain, inflammation, and infection rate. Results: The aesthetic reconstruction procedure presents a shorter healing time (8.2 ± 1.4 days vs. 21.3 ± 3.1 days; p < 0.001) with a similar recurrence rate (p = 0.98). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences (p > 0.05). Conclusions: The aesthetic reconstruction presents a shorter healing time, favoring the patients’ recuperation, with a recurrence similar to the chemical matricectomy with 88% phenol solution.

El objeto de la invención es una composición que contiene como principio activo ácido monocloroacético (MCA), en disolución con etanol (50% en volumen), preparado según un procedimiento que se describe, empleado para el tratamiento químico sistemático de la verruga plantar (papilomavirus humano plantar), sin cirugía, produciendo su cauterización química.

Los síndromes de atrapamiento nervioso conforman un conjunto de patologías que cada vez se observan con mayor frecuencia en la práctica clínica, por lo que es de gran importancia conocer su abordaje. Un síndrome de atrapamiento nervioso es el conjunto de signos y síntomas que se producen cuando una rama nerviosa es comprimida por alguna estructura anatómicas, con una etiología muy variada. La clínica principal de todos ellos es dolor y parestesias en la localización del tejido nervioso. Para su diagnóstico disponemos de diversas maniobras y test diagnósticos, además de pruebas complementarias como la RNM y las pruebas electroi siológicas para la coni rmación del síndrome. Existen distintas vías de tratamiento que utilizaremos según las características del paciente, el trayecto nervioso afectado y la evolución del cuadro. En general, se utilizara un tratamiento conservador, como el farmacológico o médico, el ortopodológico o físico entre otros. Y emplearemos el tratamiento quirúrgico en los casos con lesiones ocupantes de espacio o cuando el tratamiento invasivo no ha resultado eficaz., Nerve entrapment syndromes are a set of pathologies that are more and more observed in clinical practice, so it is very important to know its approach. Nerve entrapment syndrome is the set of signs and symptoms that occur when a nerve branch is compressed by any anatomical structure with a varied etiology. The main sign of all of them is pain and numbness in the location of the nerve tissue. We have various maneuvers and diagnostic tests for diagnosis, as well as complementary tests such as MRI and electrophysiological testing for coni rmation of the syndrome. We have several means of treatment to solve it depending on the characteristics of the patient, the nervous journey that is affected and the evolution of the symptoms. Conservative treatments, such as the medical or pharmacological, physical or orthopodologic, are generally more common. Surgical treatment is used in cases with spaceoccupying lesions or in situations where the treatment does not work noninvasive.

Background: The Surgical Safety Checklist (SSC) is a tool developed by the World Health Alliance for Patient Safety, to assist health professionals in improving patient safety during surgery. Numerous specialties have incorporated this into their clinical practice. The purpose of this study is to adapt and implement this tool within the field of podiatric surgery and to evaluate its impact upon safety standards and post-surgical complications. Methods: An analytical, observational, longitudinal study has been performed retrospectively. The implementation of the Surgical Safety Checklist in podiatric surgery took place over a 10-month period. The sample is made up from the medical histories of patients who were operated on (n = 134) in the University of Seville’s podiatric clinic. The sample was divided into three groups: those prior to the implementation process (65 subjects), those after the implementation process: without the SSC (35 subjects) and those with the SSC (34 subjects). The safety standards included in the tool were analysed in conjunction with the results and post-operative complications. Results: An improvement was seen in compliance with the Prophylaxis Protocol and the correct completion of the Informed Consent (p = 0.00), as well as a statistically significant relationship between the correct use of antibiotic prophylaxis and the use of the Surgical Safety Checklist (p = 0.049). The results demonstrate a reduction in the number of post-operative days (p = 0.012). No cases of surgery being performed in the wrong place were found in this study. Conclusions: The Surgical Safety Checklist allows us to improve compliance with the safety protocols recommended by the scientific community, and consequently to reduce the incidence of complications related to surgery and to improve patient safety during elective podiatric surgery

Background: Many risk factors have been identified to be associated with ingrown toenail. Internal pressure by the distal phalanx of the hallux and the second toe and external compression from the shoes has been proposed as a reason for the pathology. The main objective of the study was to analyze the existence of a correlation between the presence of pathological hallux interphalangeal angle (HIA) and risk of ingrown hallux nail. Methods: One hundred and sixty-five subjects (312 ft) were enrolled in a cross-sectional, analytical and observational case–control study. A radiographic computerized system was used to measure HIA in both groups. The angle was considered as the sum of three angles, obliquity, asymmetry and joint deviation. Results: The mean HIA in case group subjects (patients with hallux ingrown nail) was significantly higher than that obtained in control group subjects (17.39 ± 6.0° versus 13.47 ± 4.6°, p = .036). A total of 73.71 and 46.79 % of feet presented an angle equal or greater than 13.47° in the onychocryptosis and control group, respectively. Conclusions: The results show a correlation between the variables analysed. The presence of an HIA greater or equal than 14.5° may be a predisposing factor for developing onychocryptosis of the hallux. Clinicians treating individuals with pathology in hallux might use a baseline cutoff of HIA equal than 13.5°.

Cada vez más, la Seguridad del paciente es una prioridad para el colectivo podológico. Afortunadamente, La cirugía del lado erróneo no está descrita en la literatura podológica. Mediante la aplicación de un protocolo de prevención de cirugía en lugar erróneo conseguiremos disminuir los riesgos relacionados con la cirugía y aumentaremos la seguridad del paciente y la calidad asistencial en Podología. Podemos concluir que existe una gran imposibilidad de generar evidencia científica de su efectividad, sin embargo estos protocolos son herramientas eficientes, eficaces y de muy bajo coste que aumentan la calidad asistencial en los servicios podológicos., Increasingly, Patient Safety is a priority for the podiatry group. Fortunately, surgery on the wrong side is not described in the podiatric literature. By applying a protocol for preventing wrong site surgery able to reduce the risks associated with surgery and will increase patient safety and healthcare quality in Podiatry. We conclude that there is a failure to generate scientific evidence of its effectiveness, however, these protocols are efficient, effective and very low-cost tools to increase the quality of care in podiatric services.

The authors propose a surgical security check-list adapted to the podiatric surgery. This check-list is based on the Surgical Security Checklist proposed by the World Health Organization. The proposed document contains 18 items divided into two groups: those which are checked before the surgery and those which must be verified after it, before the patient leaves the operating room. The checklist is characterized as being an easy-to- use tool, it requires a short time and permits to systematically increase the patient safety. The authors think that the result is a checklist that is easy to fill and that improves the patient safety in the podiatric surgery

Los tumores de Koënen son manifestaciones cutáneas de la Esclerosis Tuberosa, que es de afectación sistémica y en ocasiones con localización en el pie. El conocimiento de este tipo de afecciones dermatológicas es muy importante para un tratamiento correcto y por este motivo un enfoque interdisciplinario es esencial para que el diagnóstico sea preciso y precoz. En la Historia Clínica es importante realizar una valoración de los antecedentes familiares, realizar una exploración de la piel y un estudio neurológico. Se presenta un caso con clínica compatible con la presencia de Tumor de Koënen. El diagnostico diferencial es esencial para plantear el tratamiento y conseguir un buen pronóstico y pronta curación. Conclusiones. Se plantea el tratamiento quirúrgico como técnica de elección pese a la elevada tasa de recidivas que presenta dicho tratamiento. La resección quirúrgica de la lesión permite el diagnóstico anatomopatologico., The Koenen tumors are cutaneous manifestations of tuberous sclerosis, which is of systemic involvement and sometimes with location in the foot. The knowledge of this type of dermatological is very important for proper treatment and for this reason an interdisciplinary approach is essential for the accurate and early diagnosis. In the clinical history is important to make an assessment of family history, perform a scan of the skin and a neurological study. We report a case with symptoms consistent with the presence of tumor Koenen. The differential diagnosis is essential for planning treatment and get a good outcome and speedy recovery. Conclusions. Surgical treatment is proposed as a technique of choice despite the high rate of recurrence presents such treatment. Surgical resection of the lesion allows the pathological diagnosis.

Presentación de un caso clínico de una mujer previa intervención quirúrgica de HAV mediante técnica de Osteotomía de Ludoff con resultados poco satisfactorios. Se realiza un tratamiento quirúrgico de rescate mediante el diseño de una osteotomía de Austin modificado y osteotomía de weill combinada con artrodesis del segundo dedo. Los resultados son favorables. En ocasiones, el tratamiento quirúrgico es de elección, siendo lo importante dar una respuesta al problema de salud que nos presentan nuestros pacientes, y teniendo muy presente la cirugía como una alternativa terapeútica. Lo importante es la elección adecuada de la técnica y del paciente. La osteotomía de Ludoff es una técnica estable y útil para el tratamiento de la deformidad de HAV., Presentation of a clinical case of a woman after surgery HAV by Ludoff osteotomy technique with unsatisfactory results. Surgical treatment is performed rescue by designing a modified Austin osteotomy and osteotomy combined with arthrodesis weill second toe. The results are goods. Sometimes surgical treatment is preferred, it being important to respond to the health problems that we face our patients, and highly conscious of surgery as a therapeutic alternative. What is important is the choice of technique and the patient. Ludoff osteotomy is a stable and useful technique for treating HAV deformity.

El objetivo de este trabajo es presentar los distintos tratamientos de la i brosis perineural de Morton, su etiología y manifestaciones clíni cas más frecuentes. Destacamos la importancia de la entrevista clínica y la exploración física en el diagnóstico de la patología, así como la importancia de la realización e interpretación de pruebas radiológicas complementarias. Se presenta un caso clínico cuyo tratamiento es tipo quirúrgico, tras fracasar con las distintas alternativas terapéuticas de tipo conservador., The aim of this paper is to present the diffe rent treatments of Morton perineural i brosis, its etiology and clinical manifestations frequently. We stress the importance of the clinical inter view and physical examination in the diagnosis of pathology, and the importance of performan ce and interpretation of additional radiologic tests. We present a case which is a surgical treatment after failing with therapeutic alterna tives conservative type.

En este caso pretendemos dar a conocer una patología poco frecuente en la consulta po dológica, como es la neuropatía etílica, no por ello menos importante. Como todos sabemos, es de gran importancia la sensibilidad en el pie para un correcto funcionamiento del mismo, cuando está se ve afectada, el troi smo muscu lar y cutáneo también se ven alterados. La paciente de nuestro caso presenta en la exploración ortopodológica un pie cavo varo con antepié valgo y el primer radio plan tar exionado. Tras un mal perforante plantar de larga evolución en la cara plantar del primer metatarsiano, se degeneró el tendón exor pro pio del primer dedo ocasionando un desequili brio muscular y con ello, una posición de hipe rextensión de la 1ª AMTF. La deformidad requería una solución quirúrgica inmediata, debido a la dii cultad para usar un calzado habitual, y por presentar el desequilibrio muscular que podrían crear nuevas alteraciones en el pie. Tras realizar el protocolo quirúrgico a la paciente y ser apta para la cirugía, se optó por una artrodesis de la 1ª AMTF, dado que, este procedimiento es el único capaz de alargar el radio funcionalmente., In this case we intend to present a rare con dition in podiatric consultation, such as alco holic neuropathy, no less important. As we all know, is of great importance to sensation in the foot for proper functioning, when affected, the muscular and cutaneous trophism are also al tered. The patient in our case presents an exploration ortopodológica cavus varus with fo refoot valgus and i rst ray plantar exion. After a long perforating plantar evolution in the plantar aspect of i rst metatarsal exor tendon dege nerated own i rst i nger causing a muscle imba lance and thus a position of hyperextension of the 1st MTPJ. The deformity required an immediate surgical solution because of the difi culty using a regular shoe, and muscle imbalance present which could create further changes in the foot. After performing the surgical protocol to the pa tient and be i t for surgery, we opted for a fusion of the 1st MTPJ, as this procedure is the only one capable of extending the functional radio.

Presentamos un caso clínico de una pacien te mujer de 15 años de edad que acude a con sulta por presentar una patología congénita en pie izquierdo. Presenta molestias para calzarse y deambulación, y además le supone un pro blema estético. Presenta patología asociada a sindactilia que cursa asintomática y no requie re tratamiento quirúrgico. ras la exploración se plantea tratamiento quirúrgico que consiste en una resección total de falange distal y una hemifalangectomía lateral de la falange medial del 5º dedo. l postoperatorio es de evolución favorable, con seguimiento durante los siguientes tres me ses. a importancia de este caso clínico radica en la baja frecuencia de aparición de esta pa tología en el ámbito podológico., We report a case of a female patient 15 years old, came to clinic for a congenital condition in his left foot. f discomfort in tting shoes and walking, and also results in a cosmetic problem. Presents pathology associated with syndactyly that is asymptomatic and does not require sur gical treatment. After the scan is posed surgical treatment is total resection of the distal phalanx and lateral hemi-phalangectomy phalanx of 5 nger. he postoperative evolution is right, with follow-up for the next three months. he impor tance of this case lies in the low frequency of occurrence of this disease in the podiatric eld.