title: Review of proximal interphalangeal joint excisional arthroplasty for the correction of second hammer toe deformity in 100 cases.
abstract: BACKGROUND
  The main bony procedures used in the treatment of second hammertoe are excisional arthroplasty and arthrodesis of the proximal interphalangeal (PIP) joint. While a number of studies have reported the outcomes after PIP joint arthrodesis, there are few reports of the outcome of excisional arthroplasty of the PIP joint for the correction of second hammertoes. The purpose of this study was to evaluate the long-term outcome of PIP joint excisional arthroplasty.
  
  
  METHODS
  Seventy-five patients (100 toes) who had excisional arthroplasty of the PIP joint for the correction of second hammertoe were reviewed at an average followup of 44 months. All patients were seen in clinic and were physically examined to assess the alignment and function of each digit. The radiographs were evaluated preoperatively. The AOFAS clinical rating scale was used preoperatively and at final followup. Patients were asked to rate their satisfaction on a scale of 0 to 10 and were asked if they would be happy to have the surgery under similar circumstances again.
  
  
  RESULTS
  The mean preoperative AOFAS clinical rating scale was 46. At final followup this increased to 94, showing an average improvement of 48 points (p < 0.0001). The mean satisfaction on a scale of 0 to 10 (with 0 equaling complete dissatisfaction and 10 complete satisfaction) was 9.3 (SD 1.3). One patient would not have been happy to undergo outpatient surgery again, because of a change in her social circumstances.
  
  
  CONCLUSIONS
  In a group of 75 patients who had PIP joint arthroplasty for the correction of second hammertoe, high levels of satisfaction were achieved. No serious complications were encountered, and revision surgery was required in just two cases. Floating toe was the most common complication encountered, and although this did decrease the level of patient satisfaction in seven patients it was not a cause of footwear irritation or pain in any patient.
authors.affiliation: Podiatric Surgery, Ilkeston Hospital, Heanor Road, Ilkeston, Derbyshire DE7 8LN, Great Britain. kilmartin@prima.net
authors.forename: Claire
authors.initials: C
authors.lastname: O'Kane
authors.forename: Timothy
authors.initials: T
authors.lastname: Kilmartin
mesh_terms: D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods*; D005260:Female; D037801:Hammer Toe Syndrome / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D014033:Toe Joint / Q000601:surgery*