Intraosseous Technique for Correction of Hammertoe Deformity.

Hammertoe deformities are among the most common conditions treated by foot and ankle surgeons. Many different types of proximal interphalangeal joint arthrodesis fixation techniques have been used. These include implant fixation, absorbable fixation, screw fixation, two-pin fixation, and single-Kirschner wire fixation. Each of these has their own set of associated advantages and disadvantages. One of the most common techniques to address hammertoe deformity is the use of Kirschner wires. Although Kirschner wires have been reliable and produced good outcomes, there are some drawbacks associated with their use. Some disadvantages include wire failure (bending/breaking), infection, and patient anxiety associated with removal. One of the more challenging aspects with using a single Kirschner wire for fixation is stability. Pistoning and rotational instability may occur with single-Kirschner wire use. Both pistoning and lack of rotational control can lead to nonunion, fibrous union, malunion, and ultimately patient dissatisfaction. The suturedesis technique is a surgical option that may be considered when a surgeon attempts to address these disadvantages. The authors believe this technique can adequately bring stability to the frontal plane and eliminate pistoning, which may lead to better fusion rates, better postoperative alignment, and better patient satisfaction. This article outlines the authors' surgical technique of suturedesis in correcting hammertoe deformity.