Surgical treatment of hammertoes (literature review)

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Abstract


The high prevalence of hammertoe deformity in the population, the effect of this pathology on the ability and the quality of life allow us to consider this pathology as a important medical problem. The most common surgery is arthrodesis of the proximal interphalangeal joint with a Weil-osteotomy. Specific complication is a floating toe, which leads to overload of adjacent toes and metatarsal heads. For to correct the instability of the metatarsophalangeal joint, the flexor to extensor transfer Girdlestone-Taylor can be used. However, the use of this procedure had limitations associated with difficult surgery techniques and below the average cosmetic result of the procedure. In the study of the causes of hammertoe deformity, the conclusion of the importance of the plantar plate of the metatarsophalangeal joint was made. Plantar plate repair leads to the stabilization of the metatarsophalangeal joint, reduces the risk of developing a floating toe, leads to the restoration of the support function and normal biomechanics of movement and foot function. Simultaneously, the plantar plate repair technically complicates surgical treatment. An promising direction of treatment is minimally invasive technologies for correction of hammertoe deformity that can reduce the risk of infectious complications, improve the cosmetic result of the surgery and reduce the risk of postoperative contracture in the joint, the time of the operation and rehabilitation, postoperative pain, emotional stress for the patient. However, the technique this type of surgery is more difficult, it requires a long training of the surgeon. The potential risk of intraoperative damage to various anatomical structures increases, which requires use of special tools during surgery. The choice of the surgical procedures is based on the individual characteristics of the pathological changes in the patient’s foot, the equipment of the operating room and the experience of the surgeon. It is necessary to evaluate the elasticity of the deformity, the stability of the metatarsophalangeal joint, the presence and severity of concomitant overloading metatarsalgia, as well as to take into account the subjective personalized requirements and expectations of the patient.


Dmitry S. Bobrov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: dsbmed@mail.ru
ORCID iD: 0000-0002-1190-7498
SPIN-code: 2712-8348

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, PhD, Associate Professor

Alena A. Shubkina

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: alenashubkina@gmail.com
ORCID iD: 0000-0002-9650-4822
SPIN-code: 5722-6680

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, postgraguate

Alexey V. Lychagin

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: dr.lychagin@mail.ru
ORCID iD: 0000-0002-2202-8149
SPIN-code: 3268-8609

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, PhD, Professor

Leonid Yu. Slinyakov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: slinyakovleonid@mail.ru
ORCID iD: 0000-0002-1088-5522
SPIN-code: 7483-3524

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, PhD, Professor

Leonid A. Yakimov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: dr.yakimov@gmail.com
ORCID iD: 0000-0001-6272-5048
SPIN-code: 9191-8848

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, Professor

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Supplementary files

Supplementary Files Action
1. Fig. 1. Patient V., 63 years old. Visualization of the plantar ligament of the 2nd and 3rd metatarsophalangeal joints of the right foot using magnetic resonance imaging View (126KB) Indexing metadata
2. Fig. 2. Hammer-like deformation of the 2nd toe of the right foot: the result of arthrodesis of the proximal interphalangeal joint without restoration of the capsule-ligamentous apparatus View (147KB) Indexing metadata
3. Fig. 3. Hammer-like deformation of the 2nd finger after an isolated restoration of the plantar ligament View (238KB) Indexing metadata

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