(hallux duplication)

Rare, generally isolated. This is a form of pre-axial polydactyly that most often involves both phalanges with a bifid metatarsal head. The metatarsal bone is often short.

Treatment: ideally, surgery to be performed before the child starts to walk. If the two big toes are of correct length, of good volume, amputation of the most medial toe is performed in order to avoid a scar on the medial side of the foot, sometimes annoying in the shoe. A reaxation osteotomy of the head of the metatarsal is often necessary. The metatarsal remains short and lengthening surgery is sometimes needed later.

Anesthetic implications:

general anaesthesia combined with locoregional anesthesia of the foot.

References :

-        Salazard B, Philandrianos C, Gaudeuille A.
Les malformations congénitales de l’avant-pied.
Ann Chir Plast Esth 2016; 61:519-27.

Updated: February 2022