Correction of digiti quinti varus with V-Y skin plasty often doesn't work due to...

• A. Inability of V-Y plasty to correct the deformity adequately
• B. Infection risk
• C. Excessive scarring
• D. Pain during healing

Answer: (A)

The main idea here is that a V–Y skin plasty is a soft-tissue maneuver, not a bone realignment fix. A fifth toe varus often persists because the deformity is driven by the position of the bone and the joint/tendon balance, not just the overlying skin. Advancing or lengthening skin with a V–Y flap can help with soft-tissue coverage and form, but it doesn’t correct the underlying osseous alignment or joint contracture. If the toe’s varus is due to malalignment at the metatarsophalangeal joint or tight intrinsic/flexor-tendon structures, the toe will relapse into varus after the skin heals. Therefore, the inability of the V–Y plasty to address the root deformity makes this approach unreliable for durable correction.