title: Lesser Toe PIP Joint Resection Versus PIP Joint Fusion: A Randomized Clinical Trial.
abstract: BACKGROUND
  It is unclear whether proximal interphalangeal joint (PIPJ) resection or fusion leads to superior clinical outcome in patients undergoing hammertoe surgery. The purpose of this study was to prospectively evaluate a series of patients undergoing this surgery.
  
  
  METHODS
  Patients with one or more toes with rigid PIP flexion deformity were prospectively enrolled. These patients were randomly assigned to undergo either PIPJ resection or PIPJ fusion. In addition to the PIPJ procedure, a metatarsophalangeal joint (MTPJ) release was performed if deemed necessary. Follow-up was up to 1 year postoperatively. Twenty-six patients (39 toes) were included in the PIPJ resection group and 29 (50 toes) in the PIPJ fusion group.
  
  
  RESULTS
  Thirty-four underwent an MTPJ release. No significant difference in foot outcome scores (American Orthopaedic Foot & Ankle Society scale, the Foot Function Index, and visual analog scale pain) could be detected after 1-year follow-up. A statistically significant difference was found regarding the toe alignment in the sagittal plane in favor of PIPJ fusion.
  
  
  CONCLUSIONS
  Our randomized controlled study did not show any clinical outcome difference between PIPJ fusion and PIPJ resection. Both procedures resulted in good to excellent outcome in pain and activity scores.
  
  
  METHODS
  Level II, lesser quality RCT or prospective comparative study.
authors: Department of Orthopedics, Medinova Clinics, Breda, the Netherlands Department of Orthopedics and Traumatology, Isala hospital Zwolle, the Netherlands jschrier@medinova.com.
authors: Joost C
authors: JC
authors: Schrier
authors: Department of Orthopedics, Sint Maartenskliniek, Nijmegen, the Netherlands.
authors: Noel L
authors: NL
authors: Keijsers
authors: Department of Orthopedics, University Hospital Leuven, Belgium.
authors: Giovanni A
authors: GA
authors: Matricali
authors: Department of Orthopedics, Sint Maartenskliniek, Nijmegen, the Netherlands.
authors: Jan Willem K
authors: JW
authors: Louwerens
authors: Department of Orthopedics and Traumatology, Isala hospital Zwolle, the Netherlands.
authors: Cees C P M
authors: CC
authors: Verheyen
mesh_terms: D000844:Ankylosis / Q000601:surgery*; D001174:Arthrodesis; D001178:Arthroplasty / Q000379:methods*; D005530:Foot Deformities / Q000503:physiopathology / Q000601:surgery*; D037801:Hammer Toe Syndrome / Q000601:surgery*; D006801:Humans; D007595:Joint Prosthesis; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D010147:Pain Measurement; D011859:Radiography; D012189:Retrospective Studies; D014034:Toes / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: forefoot disorders; fusion; hallux disorders; outcome studies; pip flexion deformity; resection; treatment