Diaphyseal Proximal Phalangeal Shortening Osteotomy for Correction of Hammertoe Deformity: Operative Technique and Radiological Outcomes.

Autor:	Bastías GF; Department of Orthopedic Surgery, Foot and Ankle Unit Clinica Las Condes, Hospital del Trabajador Hospital San Jose-Universidad de Chile, Santiago, Chile., Sage K; Foot and Ankle Specialists, Grand Rapids, Michigan ßaculty Michigan State University., Orapin J; Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Schon L; Institute of Foot and Ankle Reconstruction, Mercy Medical Center; Faculty MedStar Union Memorial Hospital; and Johns Hopkins School of Medicine; Baltimore, Maryland; New York University Langone, New York; and Georgetown School of Medicine, Washington, District of Columbia.
Jazyk:	angličtina
Zdroj:	Foot & ankle specialist [Foot Ankle Spec] 2024 Feb; Vol. 17 (1), pp. 29-38. Date of Electronic Publication: 2021 Jun 18.
DOI:	10.1177/19386400211012800
Abstrakt:	Background: Correction of hammertoe deformities at the proximal interphalangeal (PIP) joint results in an inherent loss of motion that can be a concern for active patients who want to maintain toe function and grip strength. Diaphyseal proximal phalangeal shortening osteotomy (DPPSO) is a joint-sparing procedure resecting a cylindrical portion of the proximal phalanx on the middiaphysis. Patients/methods: This was a retrospective review including patients treated using DPPSO with at least a 1-year follow-up. Demographic, comorbidity, and Visual Analogue Scale (VAS) scores and complication data were obtained. Radiological assessment included union status and alignment. Medial frontal anatomical (mFAA), frontal proximal interphalangeal (mFIA), plantar lateral anatomical (pLAA), and medial and plantar lateral interphalangeal angles (pLIA) were measured. Results: A total of 31 patients (45 toes) were included, with a mean age of 59 years (range: 24-72) and follow-up of 35 months (range: 12-60; mean preoperative VAS score was 4.9 ± 1.72 improving to 1.62 ± 2.28; P < .01). Union occurred in all patients at an average of 11.2 weeks. Complications were present on 4 toes (8.8%), with no recurrences. The pLIA significantly changed from 44.9° to 17.9°. There were no significant differences in the preoperative and postoperative values of the mFAA, pLAA, and mFIA. Conclusions: DPPSO provides adequate pain relief and corrects the PIP joint in the lateral plane without significantly affecting the coronal plane or the anatomical axis of the phalanx in the frontal and lateral views, nor producing secondary deformities. DPPSO is a safe, effective, and reproducible technique with a low complication rate. Levels of Evidence: Level IV: Retrospective case series . Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: GFB, KS, and JO have nothing to disclose. LS reports other support from Zimmer Biomet, grants and other from Arthrex, grants and other from Wright Medical, grants from Bioventus, grants from Omega, grants from Smith Nephew, other from Carestream, other from Elsevier, other from MiRus, other from Tetrix, other from Gerson Lehrman Group, other from Guidepoint Global, and other from Additive Orthopaedics, outside the submitted work; In addition, LS has a patent TM ankle replacement by Zimmer with royalties paid, a patent ProStop implant by Arthrex with royalties paid, a patent Toe guard, night splint Darco with royalties paid, a patent Airlift Ankle Brace DJO with royalties paid, a patent Wave plate by Wright Medical with royalties paid, and a patent Prosthetic Hindfoot Replacement issued.
Databáze:	MEDLINE
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