A Simple Method of Intramedullary Fixation for Proximal Interphalangeal Arthrodesis

Hammertoe Correction With K-Wire Fixation Compared With Percutaneous Correction

“…Classically, correction of the deformity consists of a PIP arthroplasty or fusion for fixed deformity and is often combined with additional soft tissue and bony procedures, including MTP capsulotomy, extensor tendon lengthening and release, flexor tendon release, flexor tendon-to-extensor tendon transfer, plantar plate repair, and shortening metatarsal osteotomy. 2 A traditional method of fixation, [4][5][6] used in this study, involves antegrade insertion of a Kirschner wire (K-wire) at the base of the middle phalanx distally out of the toe, followed by retrograde insertion across the PIP joint as well as across the MTP joint if necessary. Recently, several other techniques were advocated, including screw arthrodesis 7 and various implants.…”

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

“…However, our investigation did not focus at all on costs. It is easy to understand that any specialized fixation device is likely to have a base, per item, crude cost that is substantially greater than that of single (8,9) or multiple (7) K-wires used to fixate the PIPJ fusion interface. However, it is not at all clear that the use of a K-wire or multiple K-wires will be cost effective compared with a specialty fixation device.…”

“…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.…”

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

“…6 Seen as an opportunity to expand on a surgeon's choice of hardwire to avoid the risks of percutaneous fixation, many companies over the past few years have introduced new implantable, intramedullary fixation devices (IMFD) for digital arthrodesis. 1,7,8 These devices vary in configuration, material, and implantation technique. All boast the added benefit of being completely internal to reduce the infection rate with some absorbable so to not be a permanent implant in the patient.…”

“…There is a large amount of health care dollars to be saved when considering the difference in cost of a KW versus other IMFDs (approximately $1000 per digit). 8 Further cost savings can be seen in the potential of avoiding surgery-related infection. Percutaneous KW fixation infection rates range from 0% to 18%.…”