Prospective Study of Hammertoe Correction With an Intramedullary Implant

Abstract

Level IV, case series.

Arthrodesis of proximal inter-phalangeal joint for hammertoe: intramedullary device options

“…The AOFAS score (evaluated in three publications) shows a delta of 19, 45 and 58 points [ 12 , 13 , 15 ].…”

Diverging Dual Intramedullary Kirschner Wire Technique for Arthrodesis of the Proximal Interphalangeal Joint in Hammertoe Correction

“…The Smart Toe shows similar rates of fibrous union at 20%. 9 In this new age of cost containment, an important factor to consider is deciding if these new digital implants have a greater effectiveness to deem them as more cost-effective than the KW method. A recent publication reported on the idea of KW and Steinmann pins making a comeback for use of fixation in various applications throughout the foot and ankle from digital to rearfoot fusions.…”

“…1,5 However, superficial infection rates of buried KWs (single wire) have been reported at 3.5%, similar to the 0% to 5% range reported for hammertoe IMFDs. 6,9,10 Use of IMKWs add savings to the health care system with a decrease antibiotic use, follow-up office visits, and potential hospitalization compared to percutaneous KW use. Though not specific to foot and ankle surgery, Saxena et al reported that treatment of a surgical site infection can cost around US$5000.…”

Dual-Component Intramedullary Implant Versus Kirschner Wire for Proximal Interphalangeal Joint Fusion: A Randomized Controlled Clinical Trial

“…It is characterized by concomitant flexion of the proximal interphalangeal joint (PIPJ) and hyperextension of the metatarsophalangeal joint (MTPJ) (3,4). Numerous procedures have been described for the correction of the HT deformity, ranging from interphalangeal (IP) arthroplasty with or without tendon transfer and temporary Kirschner wire (K-wire) stabilization to PIPJ fusion using any of a wide range of fixation devices, including a K-wire (5,6) or wires (7), sutures (8), single and multicomponent internal fixation devices (9)(10)(11)(12)(13)(14)(15), PIPJ fusion augmented with a bone graft (16), and combinations of interphalangeal (IP) manipulations with MTPJ relocation and stabilization (17). Regardless of the surgical technique used, the goals of surgery are to correct the deformity (or limit its progression) and alleviate pain.…”