Operative repair of the fixed hammertoe deformity.
Sixty-three patients (118 toes) were evaluated at an average 61 month follow-up following PIP resection arthroplasty for a fixed hammertoe deformity. The deformity involved the second toe in 35%, the third toe in 21%, the fourth toe in 24%, and the fifth toe in 20%. The involved toe averaged 2 mm. greater length than the adjacent toes and was longer in 49/94 (52%). Seventy-eight percent of patients complained of pain preoperatively due to the hammertoe deformity and 49% complained of callus formation. Following a resection arthroplasty technique with intramedullary Kirschner wire fixation, fusion of the PIP joint occurred in 81% of toes. A fibrous union resulted in the remaining 19% of cases. Patients rated subjective alignment as acceptable in 86% of cases and radiographic alignment was rated as good in 79%. Malalignment and numbness were the major factors associated with an unsuccessful result. Pain was relieved in 92%of patients and subjective satisfaction was noted by 84% of patients. Minor complications occurred in 5%. The average postoperative AOFAS score was 83 points. Resection arthroplasty of the proximal interphalangeal joint with intramedullary Kirschner wire fixation as a technique for correction of a fixed hammertoe deformity is a reliable technique that consistently gives a high level of satisfactory results.
Coughlin
M J
MJ
Oregon Health Sciences University, Portland, USA. FOOTMD@aol.com
Dorris
J
J
Polk
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods*; D001864:Bone Wires; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013640:Tarsal Joints / Q000601:surgery*; D014034:Toes / Q000601:surgery*