Choosing the Right Hammertoe Procedure #orthopedicsurgery
Description: Hammertoe Surgery Explained: Tendon Transfer vs Resection Arthroplasty vs PIPJ Fusion #shorts
Flexibility drives treatment. Assess the deformity both weight-bearing and seated, attempt passive correction at the PIPJ, and perform a Lachman test at the MTPJ. Dorsal displacement greater than 2mm or 50% of the joint suggests plantar plate insufficiency, which should be addressed at the same time rather than left behind.
TENDON TRANSFER: FLEXIBLE DEFORMITY
Transferring FDL-FDB to the dorsal proximal phalanx converts deforming flexors into MTPJ plantarflexors during stance - restores balance lost when weak intrinsics are overpowered by stronger extrinsics.
RESECTION ARTHROPLASTY: SEMIRIGID TO RIGID, FLEXOR DRIVEN
Resecting the proximal phalangeal head shortens the flexor lever and suits elongated digits well.
PIPJ ARTHRODESIS: STABILITY OPTION
Fusion turns the digit into a rigid lever arm, allowing the long and short flexors to augment the intrinsics at the MTPJ. It is preferred when deforming forces are significant or multiple digits are involved. Fixation continues to evolve.
OPEN OR MINIMALLY INVASIVE?
A retrospective comparison of 146 toes found no statistically significant difference between MIS and open correction in time to osseous union (~8-9 wks) or return to activity.
WHY IT MATTERS BEYOND THE TOE
Finite element modeling suggests hammertoe deformity blunts the windlass mechanism and reduces plantar fascia load sharing. That may be a driver of progressive deformity and, in diabetic patients, ulceration risk.
REDUCING FAILURE
Second digit corrections and deformities with a large transverse plane component fail more often. Correcting a concomitant first ray deformity has been associated with a nearly 50% reduction in hammertoe recurrence.
SHARE your #hammertoe experience & insights
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𝗖𝗢𝗥𝗬 𝗖𝗔𝗟𝗘𝗡𝗗𝗜𝗡𝗘, 𝗠𝗗 | Orthopedic Surgeon · Franklin/Nashville, Tennessee
🌐 https://corycalendinemd.com
📅 Free joint replacement guide: https://corycalendinemd.com/free-joint-replacement-guide/
🌐 See Dr. Calendine in your Google & AI search results: https://corycalendinemd.com/preferred
📍 Bone and Joint Institute of Tennessee · 3000 Edward Curd Lane, Franklin, TN 37067
📞 (615) 791-2630
About Dr. Cory Calendine, MD - 3000 Edward Curd Lane, Franklin, TN 37067
In the operating room, I get to perform more than 700 hip & knee replacement surgeries each year. From LIVE surgical demos to viral video highlights, together let's explore - react - discuss all things related to bone and joint health. #orthopedicsurgeon #jointreplacement
THANK YOU for your comments, questions and suggestions. If there’s a medical topic or question you want me to discuss, please comment below. We are building a library of orthopedic medical video content focused on your requests and responses.
📽️ Watch latest hip & knee surgery videos ▶️ https://www.youtube.com/channel/UCtuCgnGoZNPFvJ2EzRZNHgw/videos
𝐋𝐄𝐓'𝐒 𝐂𝐎𝐍𝐍𝐄𝐂𝐓:
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𝐃𝐈𝐒𝐂𝐋𝐀𝐈𝐌𝐄𝐑𝐒:
Opinions expressed are solely my own and do not express the views or opinions of my employer. Information in this video is not intended or implied to be a substitute for professional medical advice, diagnosis and/or treatment. All content [images, digital graphics, text, and other information] contained in this video is for general information purposes only and does not replace or substitute for a consultation with a qualified physician or health professional. Close description
Flexibility drives treatment. Assess the deformity both weight-bearing and seated, attempt passive correction at the PIPJ, and perform a Lachman test at the MTPJ. Dorsal displacement greater than 2mm or 50% of the joint suggests plantar plate insufficiency, which should be addressed at the same time rather than left behind.
TENDON TRANSFER: FLEXIBLE DEFORMITY
Transferring FDL-FDB to the dorsal proximal phalanx converts deforming flexors into MTPJ plantarflexors during stance - restores balance lost when weak intrinsics are overpowered by stronger extrinsics.
RESECTION ARTHROPLASTY: SEMIRIGID TO RIGID, FLEXOR DRIVEN
Resecting the proximal phalangeal head shortens the flexor lever and suits elongated digits well.
PIPJ ARTHRODESIS: STABILITY OPTION
Fusion turns the digit into a rigid lever arm, allowing the long and short flexors to augment the intrinsics at the MTPJ. It is preferred when deforming forces are significant or multiple digits are involved. Fixation continues to evolve.
OPEN OR MINIMALLY INVASIVE?
A retrospective comparison of 146 toes found no statistically significant difference between MIS and open correction in time to osseous union (~8-9 wks) or return to activity.
WHY IT MATTERS BEYOND THE TOE
Finite element modeling suggests hammertoe deformity blunts the windlass mechanism and reduces plantar fascia load sharing. That may be a driver of progressive deformity and, in diabetic patients, ulceration risk.
REDUCING FAILURE
Second digit corrections and deformities with a large transverse plane component fail more often. Correcting a concomitant first ray deformity has been associated with a nearly 50% reduction in hammertoe recurrence.
SHARE your #hammertoe experience & insights
.
📲 SUBSCRIBE NOW for new #surgery videos
𝗖𝗢𝗥𝗬 𝗖𝗔𝗟𝗘𝗡𝗗𝗜𝗡𝗘, 𝗠𝗗 | Orthopedic Surgeon · Franklin/Nashville, Tennessee
🌐 https://corycalendinemd.com
📅 Free joint replacement guide: https://corycalendinemd.com/free-joint-replacement-guide/
🌐 See Dr. Calendine in your Google & AI search results: https://corycalendinemd.com/preferred
📍 Bone and Joint Institute of Tennessee · 3000 Edward Curd Lane, Franklin, TN 37067
📞 (615) 791-2630
About Dr. Cory Calendine, MD - 3000 Edward Curd Lane, Franklin, TN 37067
In the operating room, I get to perform more than 700 hip & knee replacement surgeries each year. From LIVE surgical demos to viral video highlights, together let's explore - react - discuss all things related to bone and joint health. #orthopedicsurgeon #jointreplacement
THANK YOU for your comments, questions and suggestions. If there’s a medical topic or question you want me to discuss, please comment below. We are building a library of orthopedic medical video content focused on your requests and responses.
📽️ Watch latest hip & knee surgery videos ▶️ https://www.youtube.com/channel/UCtuCgnGoZNPFvJ2EzRZNHgw/videos
𝐋𝐄𝐓'𝐒 𝐂𝐎𝐍𝐍𝐄𝐂𝐓:
TikTok ▶️ https://www.tiktok.com/@corycalendinemd
LinkTree ▶️ https://linktr.ee/corycalendinemd
𝐃𝐈𝐒𝐂𝐋𝐀𝐈𝐌𝐄𝐑𝐒:
Opinions expressed are solely my own and do not express the views or opinions of my employer. Information in this video is not intended or implied to be a substitute for professional medical advice, diagnosis and/or treatment. All content [images, digital graphics, text, and other information] contained in this video is for general information purposes only and does not replace or substitute for a consultation with a qualified physician or health professional. Close description