The 14 foot phalanges include proximal, middle, and distal phalanges for the lesser four toes and proximal and distal phalanges for the great toe. The phalangeal joints (MTP, PIP, DIP) are sites of hammer toe, mallet toe, and claw toe deformities. The distal phalanges of the great toe develop sesamoiditis and subungual exostosis. The proximal phalanx of the great toe is the site of Akin osteotomy for hallux valgus with proximal phalangeal valgus.
Hammer toe (PIP flexion contracture) is corrected by FDS tenotomy for flexible and PIP arthroplasty or fusion for rigid deformities. The Weil osteotomy (oblique metatarsal shortening) is the definitive procedure for MTP joint subluxation with floating toe deformity.
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