Hammertoes and clawtoes: proximal interphalangeal joint correction

Area of Science:

• Orthopedic Surgery
• Podiatry
• Foot and Ankle Deformities

Background:

• Hammertoe and clawtoe deformities are prevalent forefoot conditions.
• These deformities arise from specific underlying pathoanatomical factors.
• Common etiologies include hallux valgus, elongated metatarsals, and intrinsic foot muscle imbalance.

Purpose of the Study:

• To emphasize the importance of understanding deformity etiology for effective treatment.
• To discuss operative and nonoperative treatment strategies for hammertoe and clawtoe.
• To review proximal interphalangeal (PIP) joint correction options when conservative measures fail.

Main Methods:

• Literature review and clinical experience regarding hammertoe and clawtoe correction.
• Discussion of arthroplasty versus arthrodesis for PIP joint correction.
• Preference for PIP joint arthrodesis using intramedullary fixation over K-wires.

Main Results:

• Successful PIP correction requires a well-aligned, pain-free toe.
• PIP joint arthrodesis demonstrates advantages over arthroplasty, including reduced recurrence and predictable posture.
• Intramedullary devices mitigate complications associated with K-wire fixation.

Conclusions:

• The optimal surgical technique and fixation for PIP joint correction are still under investigation.
• Individualized patient evaluation is crucial for tailoring treatment.
• Treatment plans must consider the specific deformity, patient comorbidities, expectations, and surgeon's expertise.