The RTS® Lesser Toe is a medical-grade silicone elastomer joint replacement implant for degenerative, painful or malaligned lesser metatarsophalangeal joints. The implant has a proximal (metatarsal) stem and a distal (phalangeal) stem, each available in three lengths, and is sized intra-operatively with three colour-coded trials that match the colour code on the implant package. The implant is inserted by hand only.
Surgical technique
Joint preparation (metatarsal)
A skin incision is made over the dorsum of the lesser metatarsophalangeal joint. The distal portion of the metatarsal head is resected at the appropriate level for the existing deformity or disease. Using the supplied Reamer, prepare the medullary canal of the metatarsal. The three laser mark lines refer to the three proximal Implant stem lengths. Refer to the Sizing Chart for proximal stem lengths.
Joint preparation (phalanx)
The base of the proximal phalanx is preserved if possible. Using the supplied Reamer, the medullary canal of the proximal phalanx is prepared. Refer to the Sizing Chart dimension for distal stem lengths.
Implant sizing
Place the Implant Trials into the prepared joint in order to select the correct size of Implant. With the Trial in place, load the foot to check that there is no jamming of the Implant. The Trial is then removed and the joint is thoroughly irrigated. The colour of the chosen Trial corresponds to the colour code on the associated Implant package.
Implant placement
The appropriate Implant is then inserted. Important: hands-only insertion. Do not use forceps or other instruments to grab, grasp or insert the Implant, as this can damage the silicone Implant. Excessive handling of the Implant should be avoided. After Implant placement, flush the joint with copious irrigation.
Closure
Repair and suture the joint capsule, being certain to completely cover the Implant. Optionally, tack down the extensor digitorum longus tendon proximal to the MTP joint, using one or two absorbable sutures, with the digit just slightly plantar flexed at the MTP joint. This prevents retrograde buckling (dorsal contracture) of the joint while the foot is elevated post-operatively, allowing the joint capsule to heal in its normal position. The sutures dissolve after a few weeks, and the tendon and joint resume function. Wound closure is performed with sutures of the surgeon’s choice.
Indications
Replacement of degenerative, painful or malaligned lesser metatarsophalangeal (MTP) joints.
Indications, contraindications, warnings and precautions are listed in the instructions for use (IFU).
Sizes and ordering
Implants are supplied sterile. Codes are from CONMED's CE-market catalogue (2025) and the RTS lesser MTP surgical technique (Rev. B, 07/2019).
RTS® lesser MTP implants, sterile3 items
| Ref. | Size | Proximal stem | Distal stem |
|---|---|---|---|
| M40 SE010 | 1 | 10 mm | 7 mm |
| M40 SE020 | 2 | 13.5 mm | 8.5 mm |
| M40 SE030 | 3 | 17 mm | 10 mm |
Reference Toe System® lesser MTP instruments1 item
| Ref. | Description |
|---|---|
| M04 S0001 | Sterile single-use instrument kit, sizes 1 to 3: reamer and three colour-coded implant trials |
Codes and sizes are taken from the manufacturer's marketing literature and may change. For current information, check the ConMed website or the instructions for use before ordering.
Surgical technique & brochures
Used in
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