Removal of head of proximal phalanx.

• hammer toe causing dorsal heloma durum or recurrent ulceration that does not respond to conservative care

• Longitudinal midline incision of 2.5-3.0 cm on dorsum of toe is made
• incision deepened
• identify and coagulated vessels
• separate superficial fascia from deep fascia, extensor hood and joint capsule
• flex digit, then cut medial and collateral ligaments
• transverse transection of extensor tendon  retract
• dissect free head of proximal phalanx
• use power tool or bone cutting forceps  remove head of proximal phalanx
• smooth edges of stump of proximal phalanx
• suture extensor tendon, subcutaneous tissue and skin
• dressing for 10-14 days, surgical shoe – then remove sutures

Long term complications:
• shorter toe

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