On the right second toe, I was able to ellipse out the granulomatous tissue and send for specimen to Pathology. We also removed the Trim-It pin, which was remaining, and likely causing this soft tissue irritation.

At this point, I was able to use a rongeur, curette, and Freer to help to débride the soft tissues in the periphery of the incision site. I was then able to débride the bone as well. I was able to use a 6-2 K-wire to go from proximal to distal down the middle phalanx and distal phalanx. I then retrograded this through the proximal phalanx, and finally up into the second metatarsal head with the foot held in neutral plantar flexion.

I really don't know what direction to go with this.

he did fixate the toe???