PurposeThe overriding fifth toe is a congenital triplane deformity that may cause aesthetic and functional concerns in children and adolescents. This study aims to evaluate the results obtained when using Butler’s arthroplasty to treat this forefoot deformity.MethodsWe performed a retrospective study, including all patients undergoing Butler’s arthroplasty from January 1995 to December 2012. Clinical records were reviewed to determine age at date of surgery, gender, laterality, preoperative symptoms, success of deformity correction, postoperative pain, scarring, need for adapted shoe, rates of complications and recurrence. Patient satisfaction was evaluated through a telephone interview. All p-values < 0.05 were considered statistically significant.ResultsA total of 21 patients were included in this study, the majority of which were male (57%), with a mean follow-up of 12 months (1 to 52). In the evaluation of the residual deformity (18 patients), 72% had excellent results, 17% good and 11% poor results. One patient had a keloid scar, three patients reported pain and three patients required adapted footwear. There was a partial recurrence of the deformity in three cases. The majority of patients (78%) were satisfied with the surgery. There was no statistically significant difference in terms of results, when comparing patients older and younger than seven years of age (p = 0.46).ConclusionsButler’s operation is effective and safe in the treatment of the overriding fifth toe, yielding good functional results and patient satisfaction, with low rate of complications.Level of EvidenceIV

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up program, involving discussions between mentor and group of maximum 10 physicians. Discussion themes were informed by participant survey needs and requests. Results: 135 neurologists and 38 residents attended workshops across 3 host cities. All participants participated in the eMedical program, led by 20 mentors and supported by UCB Medical team. Surveys confirmed medical topics of greatest interest to be covered during the eMedical mentorship: drug interactions, rational polytherapy and cognition in epilepsy. High rate of willingness to continue (N95%) with program was observed. Conclusion: Dandelion touched nearly 30.000 patients lives through the innovative effective educational support of approximately 200 neurologists. There is potential for further expansion of this program in Brazil, and to grow the ''Dandelion Community". UCB-sponsored (1) Accessed on 5 May 2015 at http://apps.who.int/gb/ebwha/ pdf_files/EB136/B136_R8-en.pdf