hammertoe arthrodesis

BACKGROUND: Interphalangeal arthrodesis is a very common surgical treatment of rigid hammertoe and claw toe deformities. The K-wires habitually used in this procedure are sometimes complicated by pin tract infection, migration, discomfort, and breakage. The aim of this study is to evaluate the results of an interphalangeal arthrodesis with a new radiolucent angulated intramedullary implant. METHODS: A total of 377 implants were placed in 297 patients between October 1, 2011, and October 1, 2012...

BACKGROUND: Proximal inter-phalangeal (PIP) joint arthrodesis today represents the standard treatment for structured hammertoes; however, recently, a lot of new intramedullary devices for the fixation of this arthrodesis have been introduced. The purpose of this work is to look at the currently available devices and to perform a review of the present literature. MATERIALS AND METHODS: A literature search of PubMed/Medline and Google Scholar databases, considering works published up until September 2014 and using the keywords: hammertoe, arthrodesis, PIP joint, fusion, intramedullary devices, and K-wire, was performed...

Hammertoe is one of the most common foot deformities. Arthrodesis or arthroplasty of the proximal interphalangeal joint using temporary Kirschner wire fixation is the most widespread method of surgical stabilization. However, this type of fixation is associated with some potential complications that can be obviated if percutaneous fixation is avoided. The purpose of the present study was to prospectively collect clinical and radiographic outcomes of operative correction of hammertoe deformity using a permanently implanted 1-piece intramedullary device...

Charcot-Marie-Tooth disease is a neuromuscular disorder that commonly results in a predictable pattern of progressive bilateral lower extremity weakness, numbness, contracture, and deformity, including drop foot, loss of ankle eversion strength, dislocated hammertoes, and severe cavus foot deformity. Late stage reconstructive surgery will be often necessary if the deformity becomes unbraceable or when neuropathic ulcers have developed. Reconstructive surgery for Charcot-Marie-Tooth deformity is generally extensive and sometimes staged...

BACKGROUND: The purpose of this study was to compare the outcomes of patients with second hammertoe deformities who underwent correction using either joint resection arthroplasty, proximal interphalangeal joint (PIP) arthrodesis without osteotomy, or interpositional implant arthroplasty. METHODS: Medical records from patients who underwent second PIP correction from July 1999 to December 2008 were retrospectively reviewed. A total of 114 patients (136 second toes) were the basis for this retrospective comparative study...

UNLABELLED: A 1-piece memory Nitinol intramedullary fixation device (Smart Toe; Stryker Corporation, Kalamazoo, MI) was used for proximal interphalangeal joint arthrodesis for correction of painful hammertoes in digits 2, 3, and 4. Sixty-five implants were placed in 35 patients. The mean age of our patients was 62.2 years (range = 27-82; standard deviation = 12.5). Mean follow-up time was 27 months (range = 12-40 months; standard deviation = 7). Overall, a 93.8% fusion rate was noted...

BACKGROUND: We used finite element analysis to evaluate three techniques for the correction of hammertoe and claw toe deformities: flexor digitorum longus tendon transfer (FDLT), flexor digitorum brevis tendon transfer (FDBT), and proximal interphalangeal joint arthrodesis (PIPJA). METHODS: We performed a finite element analysis of FDLT and FDBT compared with PIPJA of the second toe using multislice computed tomography and 93 tomographic images of the foot obtained in a healthy 36-year-old man...

Kirschner wire (K-wire) fixation across the metatarsophalangeal joint (MTPJ) is commonly used in hammertoe repair surgery. The purpose of the present study was twofold: (1) to determine where the K-wire penetrates the metatarsal articular surface to achieve a rectus digit; and (2) to quantify the percentage of cartilage disruption to better understand the consequences of K-wire transfixation of the MTPJ. Arthrodesis was conducted on the second, third, and fourth proximal interphalangeal joints of 10 below-the-knee cadaver specimens, using a 1...

The present study assessed the midterm results of reconstruction for rheumatoid forefoot deformity with arthrodesis of the first metatarsophalangeal (MTP) joint, scarf osteotomy, resection arthroplasty of the metatarsal head of the lesser toes, and surgical repair of hammertoe deformity (arthrodesis of the proximal interphalangeal joint). Special focus was placed on the sagittal alignment of the first metatarsophalangeal joint after arthrodesis. We retrospectively evaluated the postoperative clinical outcomes and radiographic findings for 16 consecutive female patients (20 feet) with symptomatic rheumatoid forefoot deformities...

In cases of painful complex hammertoe deformity, there is no single approach that can be used in all circumstances. If conservative care fails, surgical management may include interphalangeal joint arthroplasty, arthrodesis, and/or plantar plate repair. The best and most pragmatic surgical plan must be patient-centered, taking the age, activity level, expectations of the patient, and precise etiology of the hammertoe deformity into account.

Hammertoes are common deformities that are often surgically treated using arthrodesis or arthroplasty of the proximal interphalangeal joint with percutaneous, temporary Kirschner wire fixation. However, percutaneous Kirschner wire fixation is associated with potential complications, including wire migration, breakage, and pin tract infection. Furthermore, the complications of pseudoarthrosis and nonunion are seen using this technique owing to a lack of rotational control of the Kirschner wire. Another drawback of this implant is the need for wire removal and the associated patient anxiety with this in-office procedure...

BACKGROUND: Fixed flexion deformity of the proximal interphalangeal joint with or without hyperextension of the metatarsaophalangeal joint, hammertoe, is one of the most common foot deformities. Many surgical options have been recommended including the use of a more flexible PDS Orthosorb absorbable pin for fixation. The authors, using the PDS pin technique, reported some coronal angulations with painful soft corns requiring surgical correction. A new proximal interphalangeal joint arthrodesis procedure for hammer toe deformities utilizing a stiffer poly L-lactate 2-mm absorbable pin for internal fixation is presented...

Hammertoe and clawtoe deformities are common forefoot problems. The deformity exists owing to the underlying pathoanatomy. Hallux valgus, longer metatarsals, and intrinsic imbalance are the most common etiologies. Understanding the cause of the deformity is important to be able to successfully treat the condition, whether nonoperative or with operative intervention. When nonoperative measures fail, PIP correction is best obtained through arthroplasty or arthrodesis. The key to successful PIP correction is obtaining a well-aligned toe and reducing pain as demonstrated by Coughlin and Mann...

Complex hammer digit deformity is commonly associated with instability of the metatarsophalangeal joint. Restoring joint stability is critical for digit alignment and function and can be challenging and unpredictable. Lesser metatarsophalangeal joint fusion might be an alternative treatment to the current soft tissue balancing, repair, and extra-articular osseous procedures used to treat joint instability. The present study was a retrospective chart and radiographic review of the pooled outcomes of 31 consecutive lesser metatarsophalangeal joint fusion procedures performed by 3 independent surgeons from May 2004 to September 2009...

Several hammertoe implant devices have recently been introduced in an attempt to provide optimal fixation for proximal interphalangeal joint arthrodesis. This article reviews these implants individually, and discusses their advantages and disadvantages. There is a lack of research with long-term follow-up available for these devices. Percutaneous Kirschner-wire fixation persists as a time-honored and effective method of fixation. The buried Kirschner-wire technique is also an effective, cost-conscious option, with many of the same advantages as newer implantable devices...

BACKGROUND: Lesser toe deformities are frequent and bothersome conditions. Many options exist for the treatment of hammertoes and clawtoes. The purpose of this study was to review our experience with the use of an intramedullary fusion device. MATERIALS AND METHODS: An IRB approved retrospective review was performed to identify 38 toes in 27 patients treated with the StayFuse (Nexa Orthopaedics) device with a mean followup of 31 months. The indications for surgery were primary deformity in 12 toes and recurrent deformities in 26 toes...

Interphalangeal joint arthrodesis is a common procedure to correct fixed or semifixed lesser toe contracture. The authors present a simple modification to end-to-end interphalangeal joint arthrodesis that increases surface area and enhances construct stability. The technique is most commonly used for the proximal interphalangeal joint and may be combined with any number of fixation techniques.

UNLABELLED: Iatrogenic flail toe is a complication of hammertoe surgery that occurs when an overaggressive resection of the proximal phalanx occurs. This can cause both functional and cosmetic concerns for the patient. We present a case report of the correction of a flail second toe in a patient with Raynaud's disease. The correction was achieved by means of gradual soft tissue lengthening with external fixation and an interposition autologous bone graft digital arthrodesis. After 5 months, this 2-stage procedure lengthened, stabilized, and restored the function of the toe...

A wide range of options is available to surgeons for fixation of the proximal interphalangeal joint when arthrodesis is undertaken for repair of the hammertoe deformity. In this technical report, we describe the use of an intraosseous loop of stainless-steel wire for permanent stabilization of the interface between the proximal and middle phalanges during fusion of the interphalangeal joint.

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