Myerson and Shereff described an anatomical basis for the correction of hammertoe deformity. Based on this model we added a metatarsophalangeal soft tissue release to a proximal interphalangeal arthroplasty as our routine method of correction of hammertoes with fixed PIP joint flexion and flexible MTP joint hyperextension.

Patients operated between March 1995 and January 2000 were retrospectively reviewed using the American Orthopaedic Foot and Ankle Society Scores (AOFAS) by independent assessors. There were 84 patients with 99 feet and 179 hammertoes with a median follow-up of 28 months. The median AOFAS score was 83. Eighty-three percent of patients were satisfied while 19% were dissatisfied with the procedure. Pain at the metatarsophalangeal joint was the commonest cause of dissatisfaction with 14% having moderate or severe pain. Nine percent had callus formation and 4% of toes were over-corrected.

There was no statistical difference in results related to the age and sex of the patient, number of toes operated on, associated hallux valgus surgery and follow-up of less than or greater than two years.

This study is based on an anatomical model and shows results comparable with other series with no recurrence of hammertoe deformity.