Soft tissue balancing procedure with CASC assessment system for postaxial polydactyly and curled fifth toe deformity

Significant improvements were observed postoperatively:PIPJ angle decreased from 33.36°±9.23° to 1.14°±0.96° (p<0.001), MTPJ angle decreased from 10.96°±6.94° to 0.63°±0.73° (p<0.001), Static appearance: All patients achieved fully exposed nails (preoperative: 0%), Aggregated CASC grade reduced from 7.57±2.13 to 2.10±0.30 (p<0.001) CONCLUSION: Polydactyly excision combined with tendon transfer balancing effectively corrects curled toe deformities without additional incisions, yielding excellent functional and aesthetic outcomes. The technique leverages existing anatomical resources, minimizing surgical morbidity.