Proximal Interphalangeal Joint Arthrodesis Combined With Minimally Invasive Closing Wedge Osteotomy of the Proximal Phalanx

Hammertoes are a common orthopedic concern characterized by flexion of the proximal interphalangeal joint (PIPJ), often with co-occurring extension of the metatarsophalangeal joint (MTPJ). Rigid deformity at the PIP joint is frequently treated with PIPJ resection arthroplasty or PIPJ arthrodesis, while the standard treatment for persistent MTPJ deformity usually involves soft tissue release, such as tendon transfers or tenotomies. Indeed, soft tissue release techniques are associated with undesirable outcomes such as incomplete correction and motor dysfunction, and lower patient satisfaction. Here we describe a novel technique for the correction of rigid hammertoe deformities that combines a PIPJ arthrodesis with a subsequent minimally invasive proximal base osteotomy of the proximal phalanx. This technique capitalizes on the stability and corrective capacity of PIPJ arthrodesis while simultaneously addressing MTPJ deformity in a fashion that preserves extensor motor function and MTPJ range of motion, while reducing soft tissue trauma. Level of Evidence : Level 4.