Coughlin M J, Dorris J, Polk E
Oregon Health Sciences University, Portland, USA.
Foot Ankle Int. 2000 Feb;21(2):94-104. doi: 10.1177/107110070002100202.
Sixty-three patients (118 toes) were evaluated at an average 61 month follow-up following PIP resection arthroplasty for a fixed hammertoe deformity. The deformity involved the second toe in 35%, the third toe in 21%, the fourth toe in 24%, and the fifth toe in 20%. The involved toe averaged 2 mm. greater length than the adjacent toes and was longer in 49/94 (52%). Seventy-eight percent of patients complained of pain preoperatively due to the hammertoe deformity and 49% complained of callus formation. Following a resection arthroplasty technique with intramedullary Kirschner wire fixation, fusion of the PIP joint occurred in 81% of toes. A fibrous union resulted in the remaining 19% of cases. Patients rated subjective alignment as acceptable in 86% of cases and radiographic alignment was rated as good in 79%. Malalignment and numbness were the major factors associated with an unsuccessful result. Pain was relieved in 92%of patients and subjective satisfaction was noted by 84% of patients. Minor complications occurred in 5%. The average postoperative AOFAS score was 83 points. Resection arthroplasty of the proximal interphalangeal joint with intramedullary Kirschner wire fixation as a technique for correction of a fixed hammertoe deformity is a reliable technique that consistently gives a high level of satisfactory results.
对63例患者（118个足趾）进行了评估，这些患者在接受近端指间关节（PIP）切除关节成形术治疗固定性锤状趾畸形后平均随访了61个月。畸形累及第二趾的占35%，第三趾的占21%，第四趾的占24%，第五趾的占20%。受累足趾平均比相邻足趾长2 mm，在94个受累足趾中有49个（52%）更长。78%的患者术前因锤状趾畸形而疼痛，49%的患者抱怨有胼胝形成。采用髓内克氏针固定的切除关节成形术技术后，81%的足趾出现了PIP关节融合。其余19%的病例形成了纤维性骨连接。86%的病例患者主观上认为对线可接受，79%的病例X线片显示对线良好。对线不良和麻木是与手术效果不佳相关的主要因素。92%的患者疼痛得到缓解，84%的患者表示主观满意。5%的患者出现了轻微并发症。术后美国足踝外科协会（AOFAS）平均评分为83分。采用髓内克氏针固定的近端指间关节切除关节成形术作为矫正固定性锤状趾畸形的一种技术是一种可靠的技术，始终能取得较高水平的满意效果。
