[Resection of the proximal phalanx in hammertoe]

Hammertoe is one of several toe deformities caused by an imbalance between tendons which flex and extend the toes. The condition is most common among women and may be caused by systemic disease, but is most often idiopathic. The standard method of operation is resection of the distal part of the proximal phalanx. We here report an evaluation of our results after operation of hammertoe at a Norwegian hospital.

After reviewing medical records for patients operated for hammertoe (at St. Olav Hospital in a 6-year-period [1999-2004]), we requested the patients to assess the intervention in a mailed questionnaire. Those who still had complaints were asked to come for a clinical check-up.

141 patients were operated for hammertoe in the period; 131 completed the questionnaire. The mean follow-up time was 5 years (range 3-8). 86% of those operated were women and the mean age at the time of operation was 65 years. 25% of the operated patients described that they had been dissatisfied with the results of the primary operation. 41% of those who had been dissatisfied had hyperextension in the metatarsophalangeal (MTP)-joint in addition to flexion in the middle joint.

A dissatisfaction rate of 25% is too high. An additional diagnosis of hyperextension of the MTP-joint requires MTP soft tissue release, which differs from the standard operation of hammertoe. We suggest that a better preoperative differentiation between the lesser toe deformities can increase satisfaction with the treatment.