Background: The aim of this study was to compare operative outcomes after lesser toe deformity correction with either proximal interphalangeal (PIP) joint arthrodesis or PIP joint resection arthroplasty.

Methods: A prospective randomized controlled trial was performed on 37 patients (48 toes) who underwent one of these two procedures. The Numeric Rating Scale (NRS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, osseous consolidation, and clinical outcome were evaluated preoperatively and at 6 weeks and 6 months postoperatively.

Inclusion Criteria:

• Patients with one or more claw toes with rigid PIP joint flexion and extension deformity of the MTP joint scheduled for surgical intervention in the investigator's department

Exclusion Criteria:

• known osteoporosis or other bone metabolism disorders
• prior surgery on the toe scheduled for the intervention
• immunodeficiency or immunosuppressive drug intake
• pregnancy
• non-palpable pulses of the posterior tibial artery or the dorsalis pedis artery
• anticoagulation therapy with the exception of acetylsalicylic acid
• a lack of sufficient physical resilience to allow free self-mobilization and walking.