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Percutaneous Flexor Tenotomy Plus Plantar Capsule Release for Rigid Hammertoe: A Cadaveric Study
Madeline Power1,2,3, Erin Bigney2,3, William Mayer1,4
1Faculty of Medicine, Dalhousie Medicine New Brunswick, Saint John, NB, Canada.
Foot & Ankle Orthopaedics
|December 24, 2025
Summary
Combining tenotomy with plantar capsule release effectively corrects rigid hammertoes in a cadaveric model. This less invasive technique shows promise for diabetic patients, potentially reducing complications and amputations.
Area of Science:
- Orthopedic Surgery
- Podiatric Surgery
- Diabetic Foot Care
Background:
- Rigid hammertoe deformities in diabetic patients pose treatment challenges.
- Percutaneous tenotomy may not address capsular contractures, and arthrodesis carries high complication risks.
Purpose of the Study:
- To evaluate the feasibility, correction magnitude, and vascular safety of combining tenotomy with plantar capsule release for rigid hammertoes.
- To assess this technique's potential as a less invasive alternative to arthrodesis.
Main Methods:
- Utilized 10 lower-limb cadaveric specimens (14 rigid hammertoes) perfused with India ink-latex.
- Measured hammertoe deformity angles preoperatively, post-tenotomy, and post-capsule release.
- Performed standard dissection to evaluate plantar digital arteries for iatrogenic injury.
Main Results:
- Mean preoperative contracture of 56.5 degrees improved by 47.4% after tenotomy.
- Plantar capsule release achieved full correction in 92% of cases not fully corrected by tenotomy alone.
- No iatrogenic injuries to plantar digital arteries were observed.
Conclusions:
- Combining tenotomy with plantar capsule release effectively corrects rigid hammertoes in a cadaveric model.
- This combined approach offers a potentially less invasive option for outpatient treatment.
- The technique may reduce risks for diabetic patients compared to arthrodesis, potentially lowering amputation rates.
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