Current And Emerging Insights On Hammertoe Correction

Start Page: 34
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Author(s): 
Christopher F. Hyer, DPM, FACFAS, and Ryan T. Scott, DPM

1. Coughlin MJ. Operative repair of the mallet toe deformity. Foot Ankle Int. 1995; 16(3):109-116.
2. Harmonson J, Harkless L. Operative procedures for the correction of hammertoe, claw toe, and mallet toe. Clin Podiatric Med Surg. 1996; 13(2):211-220.
3. Coughlin MJ, Mann RA, Saltzman CL. Surgery of the Foot and Ankle, Eighth Edition. Mosby, Philadelphia, 2007, pp. 389–390.
4. Alvine FG, Garvin KL. Peg and dowel fusion of the proximal interphalangeal joint. Foot Ankle. 1980; 1(2):90–94.
5. Taylor RG. An operative procedure for the treatment of hammertoe and claw-toe. J Bone Joint Surg. 1940; 22:607-609.
6. Zingas C, Katcherian DA, Wu KK. Kirschner wire breakage after surgery of the lesser toes. Foot Ankle Int. 1995; 16(8):504-509.
7. Reese AT, Stone NH, Young AB. Toe fusion using Kirschner wire: A study of the postoperative infection rate and related problems. JR Coll Surg Edinb. 1987; 32:158–163.
8. Caterini R, Farsetti P, Tarantino U, Potenza V, Ippolito E. Arthrodesis of the toe joints with an intramedullary cannulated screw for correction of hammertoe deformity. Foot Ankle Int. 2004; 25(4):256–261.
9. Roukis TS. A 1-piece shape-metal Nitinol intramedullary internal fixation device for arthrodesis of the proximal interphalangeal joint in neuropathic patients with Diabetes. Foot Ankle Spec. 2009; 2(3):130–134.
10. Ellington JK, Anderson RB, Davis WH, Cohen BE, Jones CP. Radiographic analysis of proximal interphalangeal joint arthrodesis with an intramedullary fusion device for lesser toe deformities. Foot Ankle Int. 2010; 31(5):372–376.
11. Konkel KF, Menger AG, Retzlaff SA. Hammer toe correction using an absorbable intramedullary pin. Foot Ankle Int. 2007; 28(8):916–920.

   For further reading, see “Minimizing The Risk Of Failed Hammertoe Surgery” in the December 2010 issue of Podiatry Today.

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Dr. Nallisays: February 6, 2012 at 11:31 am

Gentlemen,

I read your article and I just don't see the complications you are talking about. I have never had an infection using a K-wire in the toe. Implants have a much higher failure rate (positioning, failure, prolonged swelling, etc).

Performing many hammertoe corrections a year with K-wires (in for 3 weeks), I have to suggest that maybe your pre-op discussions and post-operative care don't have patient buy-in or compliance.

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Dr. Scantlinsays: February 6, 2012 at 1:32 pm

I agree with Dr. Nalli. I rarely have an issue with pin tract infection or patient anxiety. My biggest concern with any of these implantable devices is that they don't address the dorsal contracture at the MPJ, and thus I have seen too many "floating toes." I never have that problem when I use K-wires. Out of curiosity, for those surgeons who do use them, what are surgeons doing to prevent floating toes? Skin plasty's?

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Joshuasays: February 9, 2012 at 5:32 am

Great article.

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Ed Davis, DPMsays: February 22, 2012 at 11:46 pm

I agree with Dr. Scantlin concerning the need to adequately address the deformity at the MTP joint. The various PIPJ implant devices do a good job of holding the joint in alignment but do so in rigid alignment. Fusion of the PIPJ yields a straight toe but one that is often painful in shoegear.

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