The optimal management of a complex hammertoe deformity, with fixed contractures, remains a clinical and surgical challenge. Numerous surgical techniques have been described for correction of this lesser toe deformity, predominately achieving correction through alteration of both the proximal interphalangeal joint and the metatarsophalangeal joint of the affected toe. The technique presented here uses the metatarsophalangeal joint for treatment of this sagittal plane deformity, accomplished through a metatarsophalangeal joint resection arthroplasty combined with soft tissue interposition. And when reserved for the digit that is not amenable to (or has already failed) standard hammertoe surgical intervention its degree of correction can be quite powerful. This procedure is consistent and durable in nature, and converts a malaligned functionless painful toe into an aligned, painless, and passively flexible digit.