Taking A Novel Approach To Hammertoe Surgery
- Volume 19 - Issue 1 - January 2006
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How The Procedure Offers Key Benefits
The success of these procedures is due to the location of our incision and the minimal contact/pressure of the incision site. Neurovascular insult is always a concern. However, one can make the incision parallel to the neurovascular structures in order to minimize the risk of any trauma that could occur.
The location of our incision also provides adequate exposure to the structures for surgical correction. This helps simplify the technique. The procedure spares tendons the risk of accidental transection that can occur more frequently through more traditional incisions. There is also increased postoperative stability of the digit with minimal trauma to the periarticular structures.2
Another benefit of the procedure is that patients do not bear weight on the surgical site. This is particularly ideal for fifth digit procedures in preventing scarring, pain and possible dehiscence. The procedure also reduces a possible flail toe as the surgeon would not transect the extensor tendon.
Additionally, one may correct a mallet toe in the same fashion as a hammertoe by extending the incision distally for exposure. Finally, the cosmetic result lends itself to higher numbers of satisfied patients.
With plastic surgery techniques becoming popular in foot surgery, we believe that the medial/lateral technique is a superior approach to digital surgery. It is relatively easy in terms of technical difficulty and a surgeon can perform it within the same amount of time as a traditional incision. The medial incision increases the chance that patient is more apt to have appropriate surgical management.
Dr. DeBello is a Fellow of the American College of Foot and Ankle Surgeons. He is a Diplomate of the American Board of Podiatric Surgery and is board certified in foot surgery. He is affiliated with the Podiatric Surgical Department at the Our Lady of Mercy Hospital in Bronx, N.Y.
Dr. DeCoteau is affiliated with the Podiatric Surgical Department at the Our Lady of Mercy Hospital at Bronx, N.Y.
Dr. Beatty is affiliated with the Podiatric Surgical Department of Our Lady of Mercy Hospital in Bronx, N.Y.
Dr. Burks is a Fellow of the American College of Foot and Ankle Surgeons, and is board certified in foot and ankle surgery. Dr. Burks practices in Little Rock, Ark.
Editor’s Note: For related articles, see “How To Handle Complications Of Hammertoe Surgery” (page 36, September 2005 issue) or “The Top Eleven Pearls For Hammertoe Surgery” (page 24, April 2002 issue). Also visit the archives at www.podiatrytoday.com.
1. Mozena JD, Yeske M, Jones PC. Hammertoe surgery and the medial incisional approach. Podiatry Today. December:50-53, 1998.
2. Ohm OW, McDonnel M, Vetter WA. Digital Arthrodesis: An Alternate Method for Correction of Hammer Toe Deformity. Journal of Foot Surgery. 29(3):207-211, 1990.
3. Gazdag A, Cracchiolo A. Surgical Treatment of Patients with Painful Instability of the Second Metatarsophalangeal Joint. Foot and Ankle Int. 19(3):137-143, 1998.
4. Mendicino RW, Statler TK, Saltrick KR, Catanzariti AR. Predislocation Syndrome: A Review and Retrospective Analysis of Eight Patients. J Foot Ankle Surg. 40(4):214-224, 2001.