Hammer Toe Correction Comparative Study
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This study compared outcomes of 3 surgical treatments for hammertoe deformities: arthroplasty, arthrodesis, and interpositional implant arthroplasty. 114 patients underwent one of the procedures and were followed for at least 12 months. All treatments significantly improved pain and sagittal plane correction, but only implant arthroplasty provided significant transverse plane correction and had the lowest revision rate at 10.4%. The study demonstrates implant arthroplasty may have advantages over the other procedures for hammertoe correction.
Hammer Toe Correction Comparative Study
- 1. Hammertoe Deformity Treatments: A Retrospective Comparative StudyAuthors: Wenjay Sung, DPM,Lowell Weil, Jr., DPM, and Lowell Scott Weil, Sr., DPM.DisclosuresMy disclosure is in the Final AOFAS Program Book.I have no potential conflicts with this presentation.LSW is a consultant for Wright Medical Technologies and receives royalties from the Weil Hammertoe Implant.LWJ is a consultant for Wright Medical Technologies
- 2. PurposeTo compare the long-term outcomes of second hammertoe deformities that underwent proximal interphalangeal (PIP) joint correction using arthroplasty, arthrodesis or interpositional implant arthroplasty. Retrospective Comparative StudyEBM Level of evidence: III (Therapeutic)
- 3. PurposeBackgroundIndications for surgical correction of hammertoe8Pain Pressure over the dorsal aspect of the PIP joint DeformityThere are many reports regarding the outcomes of PIP joint implant arthroplasty1-3, PIP arthrodesis4-6, and PIP arthroplasty7.However there are no studies that compare the outcomes of all three with significant follow-up.
- 4. MethodsWe retrospectively reviewed medical records of patients who underwent second PIP joint deformity correction between January 1998 to December 2008. A total of 114 patients (136 cases) were included in the study with at least 12 months of follow-up.AssessmentVisual analog pain scale (VAS)Anterior-posterior (AP) and lateral (LAT) radiographic views were evaluatedSecond PIP joint angles was measured onsagittal and transverse planes
- 5. MethodsSeparated into three treatment groupsArthroplastyArthrodesisImplant
- 7. Statistical AnalysisAll statistical analysis were performed with SPSS version 14.0 (SPSS Science Inc, Chicago, Ill). We used a two-way repeated measures analysis of variance (ANOVA). Inferential statistics included paired two-tailed t tests for continuous variables. The a priori α level was .05 for all statistical tests.
- 8. ResultsDemographics & RevisionsArthroplastyAverage follow-up of 45.3 months39 patients/ 45 cases with an average age of 62.7Seventeen (37.8%) cases elected revision surgery.ImplantAverage follow-up of 67.4 months41 patients/ 48 cases with an average age of 67.4Four (10.4%) cases elected revision surgery.ArthrodesisAverage follow-up of 47.8 months34 patients/ 43 cases with an average age of 55.5 Six (14.6%) cases elected revision surgery.
- 10. DiscussionOur study demonstrates that all three techniques Significantly improves painSignificantly corrects in the sagittal plane (LAT).However, only the implant group significantly corrected the deformity in the transverse plane (AP).Moreover, surgical revisions were lowest in this group. There are many studies that demonstrate good results of different techniques1-7, however, this study is the first to compare the results of three popular hammertoe treatments with long-term follow-up.
- 11. DiscussionStrengthComparative studyStatistical analysisFollow-upWeaknessObserver bias Variability in patient selection. Underpowered to determine variance
- 12. ConclusionsIn conclusion, our study confirms that all three techniques provide adequate pain relief and sagittal plane correction. However, interpositional implant arthroplasty provides significant correction in the transverse plane with less chance for revision surgery.
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