We sought to determine the optimum surgical treatment of claw and hammer
toes (except for the hallux) on the basis of the specific pathological
anatomy of each type of deformity. We dissected thirty-three fresh-frozen
specimens that had been obtained from below-the-knee amputations. The
specimens included ten normal feet, fourteen feet that had claw toes, six
feet that had hammer toes, and three feet that had an uncategorized
deformity. The contributions of abnormalities of the skin, tendons, joint
capsule, and collateral ligaments to deformity of the metatarsophalangeal
and proximal interphalangeal joints were determined by sequential
sectioning of all of those soft-tissue components. Any alteration in the
range of motion of the joints was recorded after each stage of the
dissection. The findings of this study suggested that surgical correction
of claw and hammer toes may necessitate more extensive sectioning of the
soft tissues than had previously been believed.