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Toe deformity from prolonged pulse oximetry
  1. D Lindo1,
  2. D Browne1,
  3. J Lindo2
  1. 1Neonatal Unit, Kingston Hospital, Galsworthy Road, Kingston upon Thames, Surrey KT2 7QB, UK; dlindo{at}
  2. 2Department of Public Health Sciences, St George's Hospital Medical School, London, UK

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We have seen toe deformities in three of our babies who needed prolonged pulse oximetry. The deformities started to manifest beyond the age of 3 months. They consisted of elevation of one or more of the second to fourth toes (see figs 1 and 2) and persisted in the three children at the ages of 12, 18, and 30 months respectively, though not while weight bearing in the latter.

There are well described complications of pulse oximetry, including burns1 and finger injury.2 We are, however, not aware of any previous documentation of toe deformity as a possible complication.

This deformity, although possibly transient, causes concern to the parents and health care staff. Some of the possible explanations for the deformities could include how firmly the probes are being applied or the frequency with which they are re-sited. The use of splints to support the toes during oximetry may help to prevent the deformities.

We have started placing the probes more proximally on the feet and are re-siting them at three hourly intervals instead of 4–6 hourly. This is a preventable consequence and we should therefore be cautious and vigilant in our use of pulse oximetry.


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