Hammer Toe Correction with Proximal Interphalangeal Joint Arthrodesis

Area of Science:

• Orthopedic surgery
• Podiatric surgery
• Foot and ankle reconstruction

Background:

• Hammer toe, a fixed-flexion deformity of the proximal interphalangeal joint (PIPJ), is commonly treated with arthrodesis.
• Deformity often results from intrinsic and extrinsic muscle imbalances affecting the interphalangeal and metatarsophalangeal joints.
• Surgical correction involves PIPJ straightening and arthrodesis combined with soft-tissue balancing of the metatarsophalangeal joint (MTPJ).

Purpose of the Study:

• To describe the surgical technique for proximal interphalangeal joint arthrodesis in hammer toe correction.
• To discuss alternative treatments and the rationale for choosing arthrodesis.
• To outline expected outcomes, potential complications, and important surgical considerations.

Main Methods:

• Surgical exposure of the PIPJ via longitudinal incision, extensor tenotomy, and capsulotomy.
• Resection of articular surfaces of the proximal and middle phalanges for osseous apposition.
• Soft-tissue balancing of the MTPJ, including tendon lengthening and ligamentous release, followed by Kirschner wire fixation or alternative implants.

Main Results:

• High rates of osseous fusion (83%–98%) and patient satisfaction (83%–100%) are reported.
• Effective pain relief is achieved in up to 92% of patients.
• Novel internal fixation devices improve cosmesis and reduce the need for secondary procedures.

Conclusions:

• Proximal interphalangeal joint arthrodesis is a reliable and effective surgical treatment for hammer toe deformity.
• The procedure offers significant pain relief and high patient satisfaction rates.
• Careful surgical technique and appropriate fixation are crucial for optimal outcomes.