A second webspace incision was made. Sharp dissection was carried down through the subcutaneous tissue. Dissection was carried down into the intermetatarsal area. The intermetatarsal ligament was identified and under direct vision was divided. Dissection was carried down to the digital nerve. It was identified. It was traced back proximal into the plantar musculature, and sharply divided. The nerve was then dissected out as it branched into the second and third toes. Once it was a cm into the toes, the nerve was identified, freed of adjacent vascular structures, and sharply divided. The nerve will be sent for evaluation.
The lateral MTP capsule was then opened. Minimal synovitis was encountered, but there was some medial deviation. The joint was then copiously irrigated. With the MTP joint reduced, a capsulorrhaphy and repair of the medial collateral structure of the MTP joint was performed with 3-0 PDS suture. An overriding tightening, and reefing of the lateral capsule was also performed with a 3-0 PDS.