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Related Concept Videos

Ankle Joint01:10

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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Hammer Toe Correction with Proximal Interphalangeal Joint Arthrodesis.

Eric Olsen1, Jesse King2, Jordan R Pollock3

  • 1University of Michigan Medical School, Ann Arbor, Michigan.

JBJS Essential Surgical Techniques
|January 26, 2024
PubMed
Summary

Arthrodesis of the proximal interphalangeal joint effectively treats hammer toe deformities by fusing the joint, offering high patient satisfaction and pain relief. This surgical method provides reliable fixation and favorable outcomes for correcting fixed-flexion deformities.

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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.