経皮的ハンマートゥ矯正術（関節外骨切り術）: 患者報告アウトカムおよび合併症の後ろ向き研究

To evaluate the clinical and functional outcomes of percutaneous correction of lesser toe deformities using extra-articular osteotomies, with a focus on patient-reported outcomes and postoperative complications.

A retrospective review was conducted on 98 percutaneous hammertoe correction procedures performed on 41 patients between April 2019 and April 2024. Inclusion criteria included age >18, minimum 12-month clinical follow-up, and pre- and post-operative radiographs. Procedures involving interphalangeal arthrodesis or isolated fifth toe corrections were excluded. Functional outcomes were assessed using the Foot Function Index (FFI) pre-operatively and at least one year post-operatively. Statistical analysis was performed using paired t-tests. Complications and concomitant procedures were also recorded.

Patients had a significant improvement in overall FFI scores, from a pre-operative average of 86.3 to a post-operative average of 34.9 (p < 0.0001). Subscale improvements were also statistically significant for pain (p < 0.0001) and disability (p < 0.0001), but not for activity limitation (p = 0.06). Common concomitant procedures included percutaneous hallux valgus correction (46%) and distal metatarsal metaphyseal osteotomies (39%). The most frequent complications were recurrence requiring revision arthrodesis (7%) or capsular release (5%). No infections or wound complications were reported.

Percutaneous correction of lesser toe deformities using extra-articular osteotomies offers a safe and effective alternative to traditional open techniques. The procedure significantly improves patient-reported outcomes with a low complication rate and high patient satisfaction. Further research, including long-term follow-up and comparison with open techniques, is warranted.

3 - Therapeutic Study, Retrospective Comparative study.