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Updated: Dec 29, 2025

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Risk Factors for Failure in Hammertoe Surgery.

Rachel H Albright1,2, Moiz Hassan1, Jacob Randich1

  • 1Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA.

Foot & Ankle International
|February 7, 2020
PubMed
Summary

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Hammertoe surgery can fail due to specific risk factors like increased toe deviation and certain surgical techniques. Performing first ray surgery may reduce hammertoe recurrence by 50%.

Area of Science:

  • Foot and Ankle Surgery
  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Hammertoe correction is a common elective foot surgery.
  • High rates of symptomatic recurrence and revision surgery are noted.
  • Identifying risk factors for hammertoe surgery failure is crucial.

Purpose of the Study:

  • To identify patient and provider risk factors associated with hammertoe surgery failure.
  • To provide guidance for surgeons in preoperative consultations.
  • To help patients set realistic postoperative expectations.

Main Methods:

  • Retrospective cohort study of 152 patients (311 toes) undergoing hammertoe surgery.
  • Minimum 6-month follow-up in a single urban foot and ankle practice.
Keywords:
arthroplastyhammertoeoutcome studyrecurrencerisk factors

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  • Cox regression analysis used to identify predictor variables from chart and radiographic review.

    • Main Results:

    • Increased preoperative transverse plane deviation, operating on the second toe, and using phalangeal osteotomy for proximal interphalangeal (PIP) joint reduction were significant predictors of failure.
    • Less conventional PIP joint reduction techniques also increased failure risk.
    • Concomitant first ray surgery reduced hammertoe recurrence by 50%.

    Conclusions:

    • Identified risk factors can guide surgeons during preoperative consultations.
    • This information can improve patient understanding of postoperative expectations.
    • Understanding these factors may lead to better outcomes in hammertoe correction surgery.