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hammer toe arthrodesis

D Arbab, D Frank, B Bouillon, C Lüring
OBJECTIVE: Realignment and pain relief of toes 2-5 by flexor-to-extensor tendon transfer of the flexor digitorum longus (FDL) muscle. INDICATIONS: As an isolated procedure in flexible proximal interphalangeal (PIP) joint flexion and/or flexible metatarsophalangeal (MTP) joint extension (hammer toe). In combination with a metatarsal osteotomy or PIP joint arthrodesis in case of flexible MTP joint extension. CONTRAINDICATIONS: General medical contraindications to surgical interventions...
July 4, 2017: Operative Orthopädie und Traumatologie
James P Sullivan, Catherine L Churchill
Foot and ankle surgeons frequently treat digital deformities of the lesser toes surgically. Arthrodesis of the proximal interphalangeal joint is the workhorse procedure for correction of hammer toe contractures. Fusion of the interphalangeal joint can be fixated with a variety of methods, including K-wire fixation, intramedullary implants, absorbable pins, and screws. Each method of fixation has advantages and disadvantages, such as variations in complication rates, cost, and fusion rates. Further research is necessary to determine the best method of fixation for digital interphalangeal joint fusion...
July 2017: Clinics in Podiatric Medicine and Surgery
Faiz Khan, Shiori Kimura, Tayyab Ahmad, Darren D'Souza, Lester D'Souza
BACKGROUND: Arthrodesis of small joints for hammer and claw toe deformities is a common forefoot operative procedure. Our objective was to review patients who underwent small toe arthrodesis with Smart Toe(©) intramedullary monobloc implant. Our aim was to assess patient's surgical outcome and to ascertain implant suitability. METHODS: This procedure was undertaken in 90 patients from February 2011 to December 2012. We present our review of 82 (91.1%) patients who attended the final six 6-month follow up...
June 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Paolo Ceccarini, Alfredo Ceccarini, Giuseppe Rinonapoli, Auro Caraffa
Existing techniques for surgical treatment of hammer toe commonly combine skeletal and soft tissues interventions to obtain a durable correction of the deformity, balance the musculotendinous forces of flexion and extension of the toe, and normalization of the relations between interosseous muscles and metatarsal bones. The most common surgical techniques can provide the correction of the deformity through arthroplasty with resection of the head of the proximal phalanx or arthrodesis of the proximal interphalangeal joint...
July 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
H Waizy, M Abbara-Czardybon
OBJECTIVE: Elimination of the fixed lesser toe deformity by arthrodesis of the proximal or distal interphalangeal joints (PIP and DIP, respectively). INDICATIONS: Painful fixed deformity. PIP joint: fixed hammer toe or clawtoe. DIP joint: fixed mallet toe. Relative indication: flexible hammer toe, clawtoe or mallet toe. CONTRAINDICATIONS: General operative contraindications. Relative contraindications also include severe deformities affecting the metatarsophalangeal (MTP) joint, for which the arthrodesis should combine an operative procedure of the MTP joint...
June 2014: Operative Orthopädie und Traumatologie
Jaytinder S Sandhu, William T DeCarbo, Mark H Hofbauer
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...
October 2013: Foot & Ankle Specialist
Javier Bayod, Ricardo Becerro de Bengoa Vallejo, Marta Elena Losa Iglesias, Manuel Doblaré
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...
July 2013: Journal of the American Podiatric Medical Association
Charles M Zelen, Nathan J Young
For lesser toe deformities, fusion of the proximal interphalangeal joint offers good long-term correction and predictability. Digital arthrodesis has been described for longer than 100 years in the literature, and current techniques closely resemble those described in early accounts. However, many implants currently being used take advantage of the latest metallurgic and polymeric innovations, with implants being composed of nitinol, polylactic or polyglycolic acids, and polydioxanone. Newer implants offer easy insertion and good stability, with no percutaneous wires...
July 2013: Clinics in Podiatric Medicine and Surgery
Alex Scholl, James McCarty, Desiree Scholl, Alice Mar
The surgical correction of hammer digits offers a variety of surgical treatments ranging from arthroplasty to arthrodesis, with many options for fixation. In the present study, we compared 2 buried implants for arthrodesis of lesser digit deformities: a Smart Toe® implant and a buried Kirschner wire. Both implants were placed in a prepared interphalangeal joint, did not violate other digital or metatarsal joints, and were not exposed percutaneously. A retrospective comparative study was performed of 117 digits with either a Smart Toe® implant or a buried Kirschner wire, performed from January 1, 2007 to December 31, 2010...
September 2013: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Stephen J Kominsky, Roberto Bermudez, Alvin Bannerjee
UNLABELLED: Digital contractures are a very common deformity of the foot and ankle that require surgical correction. It has been shown that arthrodesis provides a better long-term result than arthroplasty of the interphalangeal joints. Arthroplasties usually require K-wire fixation that presents potential complications, such as pin tract infection. This study presents a new cadaveric bone matrix allograft to be used as rigid internal fixation for proximal interphalangeal joint arthrodesis...
April 2013: Foot & Ankle Specialist
Zeev Feldbrin, Alexander Lipkin, David Hendel, Dror Lakstein
Proximal interphalangeal joint (PIP) arthrodesis is a very common procedure in the practice of foot and ankle surgeons. The standard technique recommends using a Kirschner wire (KW) with double sharp ends. Using this technique there are some complication that can be eliminated by small modification. The technique of proximal interphalangeal joint arthrodesis using a simple blunt KW on one side with an accurate placement and avoidance of metatarsophalangeal joint (MTPJ) penetration without the need for fluoroscopy is described...
March 2013: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
N Gutteck, S Lebek, F Radetzki, D Wohlrab, K-S Delank
Deformities of the small toes often occur with complex forefoot deformities. Proximal interphalangeal joint arthrodesis is a reliable correction procedure for rigid flexed proximal interphalangeal joints. The most often performed technique by far is K-wire fixation; however, pin tract infections, malrotation due to deficient securing of the rotation and irritation of the metatarsophalangeal joints are common complications. By using a 0.4 mm wire cerclage an individual position of the proximal interphalangeal joint in slight flexion is enabled whereby good compression can be achieved and malrotation can be avoided...
December 2012: Der Orthopäde
Arush K Angirasa, Michael J Barrett, Darren Silvester
For many years, end-to-end arthrodesis of a proximal interphalangeal joint arthrodesis to correct hammer digit deformity has been fixated with a Kirschner wire (K-wire). For this particular hammer digit deformity correction, we attempted to determine the effectiveness of the SmartToe(®) intramedullary shape memory implant compared with the K-wire. In a retrospective analysis of 28 cases, we evaluated several important parameters at baseline, postoperative days 7, 14, 21, 28, and 56, and 6 months for pain, complications, arthrodesis achieved, and return-to-work status...
November 2012: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Klaus J Kernbach
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.
July 2012: Clinics in Podiatric Medicine and Surgery
Bryan L Witt, Christopher F Hyer
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...
July 2012: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Xiaojun Duan, Liu Yang, Gang Dai, Xu Peng
OBJECTIVE: To evaluate the surgical treatment and effectiveness of rheumatoid forefoot reconstruction with arthrodesis of the first metatarsophalangeal joint and arthroplasty of lesser metatarsal heads. METHODS: Between January 2007 and August 2009, 7 patients with rheumatoid forefoot were treated by reconstruction with arthrodesis of the first metatarsophalangeal joint and arthroplasty of lesser metatarsal heads. They were all females with an average age of 62 years (range, 56-71 years) and with an average disease duration of 16 years (range, 5-30 years)...
April 2012: Chinese Journal of Reparative and Reconstructive Surgery
Kurt F Konkel, Eric R Sover, Andrea G Menger, Jennifer M Halberg
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...
October 2011: Foot & Ankle International
J Kent Ellington
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...
December 2011: Foot and Ankle Clinics
Andrew Molloy, Raheel Shariff
Mallet toe is one of the most common deformities encountered by orthopedic surgeons. Care needs to be taken to ascertain whether it is a primary condition or secondary to a systemic disease, especially if multiple deformities are present. There are numerous operative strategies available, but each has its specific indications. If the indications are followed, highly successful outcomes may be achieved.
December 2011: Foot and Ankle Clinics
Robert Joseph, Kevin Schroeder, Marc Greenberg
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...
January 2012: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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