TREATMENT OF SYMPTOMATIC HAMMERTOE WITH A PROXIMAL INTERPHALANGEAL JOINT ARTHRODESIS

This study examined 76 consecutive patients (100 feet) treated by a si ngle surgeon for both flexible and rigid hammertoes with a PIP arthrod esis using custom-machined drills, a peg cutter, and hole cutter, comb ined with an extensor tenotomy and dorsal capsulotomy. Forty-eight per cent of patients were defined as satisfied without reservation, 37% we re defined as satisfied with reservations, and 15% were defined as dis satisfied. The incidence of radiographic fusion was 95% (130/137 toes) . The most common reasons for either reservation or dissatisfaction in cluded incomplete pain relief, residual toe angulation, and prolonged shoe wear restriction in the postoperative period. Based upon the resu lts of this study, the authors suggest that when using a peg and socke t arthrodesis for hammertoe correction (1) there is a 95% rate of radi ographic fusion, (2) patients over 65 years old be alerted to a dimini shed rate of satisfaction, and (3) a distal flexor tenotomy be conside red in patients with a preoperative DIP flexion contracture.