Ainhum

Working in a government hospital has its own charm. Surprised to hear that? Well, I mean managing the cases with limited drugs and instruments. I remember how I struggled once disarticulating a gangrenous toe in minor OT. But here you see this typical picture showing a not so common condition called Ainhum which undergoes spontaneous amputation (autoamputation) in a span of few years.

Ainhum, also known as bankokerend, dactylolysis spontanea or sukhapakla is a painful fibrous constriction usually bilateral and involving base of the fifth toe. The disease is comparatively common among farmers who walk bare foot but the exact etiology is not known.

This patient presented to us with the complaints of pain on walking and wearing shoes. After a detailed interview and examination we found that left 5th toe had already undergone autoamputation 2 years back. Since radiograph showed involvement of bone, we opted for disarticulation of 5th metatarsophalangeal joint and patient was happy to have his symptoms relieved.