Treatment of symptomatic hammertoe with a proximal interphalangeal joint arthrodesis.
This study examined 76 consecutive patients (100 feet) treated by a single surgeon for both flexible and rigid hammertoes with a PIP arthrodesis using custom-machined drills, a peg cutter, and hole cutter, combined with an extensor tenotomy and dorsal capsulotomy. Forty-eight percent of patients were defined as satisfied without reservation, 37% were defined as satisfied with reservations, and 15% were defined as dissatisfied. The incidence of radiographic fusion was 95% (130/137 toes). The most common reasons for either reservation or dissatisfaction included incomplete pain relief, residual toe angulation, and prolonged shoe wear restriction in the postoperative period. Based upon the results of this study, the authors suggest that when using a peg and socket arthrodesis for hammertoe correction (1) there is a 95% rate of radiographic fusion, (2) patients over 65 years old be alerted to a diminished rate of satisfaction, and (3) a distal flexor tenotomy be considered in patients with a preoperative DIP flexion contracture.
Lehman
D E
DE
Department of Orthopaedic Surgery, Indiana University Medical Center, Indianapolis 46202, USA.
Smith
R W
RW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery; D014033:Toe Joint / Q000000981:diagnostic imaging / Q000601:surgery*