Effectiveness of the Cobb-Stainsby excision arthroplasty

Foot Ankle Surg. 2018 Feb;24(1):49-53. doi: 10.1016/j.fas.2016.11.007. Epub 2016 Nov 25.

Abstract

Background: Dislocated metatarsophalangeal joints from clawed or hammer toes can be a disabling consequence of several conditions. The Cobb-Stainsby forefoot arthroplasty combines partial phalangectomy (Stainsby) with extensor tendon transfer to the metatarsal head (Cobb). We present a retrospective, three surgeon case series of 215 toes in 126 patients.

Methods: Early results and complications were gathered from the medical charts of 126 patients who met the inclusion criteria. Seventy-five patients were contactable by phone with a follow up range of 12-82 months (median follow up 45 months). Primary outcome measures were improvement of pain and function, reduction in plantar callosities and cosmetic improvement of the deformity.

Results: Pre-operatively all patients presented with pain and shoe wear problems. Post-operatively seventy-two patients (96%) were satisfied, 72 (96%) reported pain relief, 55 (73%) were happy with toe control, 61 (81%) were pleased with cosmesis and 56 (75%) reported unlimited daily activities. Superficial wound infections were observed in 13 of the 126 patients (10%) and two in 75 patients (2%) developed recurrent clawing.

Conclusion: Our case series demonstrates improved outcomes over alternatives such as the Weil's osteotomy.

Keywords: Claw toe; Hallux valgus; Hammer toe; Metatarso-phalangeal joints; Plantar plate; Stainsby.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty
  • Female
  • Foot Deformities, Acquired / etiology
  • Foot Deformities, Acquired / surgery*
  • Hammer Toe Syndrome / etiology
  • Hammer Toe Syndrome / surgery*
  • Humans
  • Male
  • Metatarsal Bones / surgery
  • Metatarsophalangeal Joint / injuries
  • Metatarsophalangeal Joint / surgery*
  • Middle Aged
  • Retrospective Studies
  • Tendon Transfer
  • Toe Phalanges / surgery
  • Young Adult