Interphalangeal Arthrodesis of the Toe With a New Radiolucent Intramedullary Implant (Toegrip)

Abstract

Therapeutic, Level IV: Case series.

A Midterm Review of Lesser Toe Arthrodesis With an Intramedullary Implant

“…When conservative treatments fail, surgical correction is indicated. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Many surgical options have been described to address the complex nature of these deformities but no perfect solution has been reported to date. 3 Surgical options range from soft tissue procedures aimed at rebalancing the digital contractures, to excisional arthroplasty, which realigns the joint through decompression and finally interphalangeal (IP) joint arthrodesis, used to stabilize the toe by fusing the IP joint giving the flexor tendons a mechanical advantage by creating a longer, more stable lever arm.…”

“…Disadvantages relate to patient dissatisfaction due to a toe that is too straight or the development of a flexion deformity at the DIPJ (mallet toe). [8][9][10][11][12][13][14][15][16][17] Technically, arthrodesis is more demanding and ideally needs internal fixation, which brings its own complications. 8 Various fixation devices have been reported in the literature both internal and external with the most common device used being the retrograded Kirschner wire.…”

“…8 Various fixation devices have been reported in the literature both internal and external with the most common device used being the retrograded Kirschner wire. [8][9][10][11][12][13][14][15][16][17] Complications include pain and discomfort, pin tract infection, breakage, bending, migration and a lack of rotational stability to allow fusion. One must also mention the inconvenience of a percutaneous wire as it restricts shoe fitting and bathing for up to 6 weeks.…”

“…Along with the advancement of internal fixation technology, and the issues surrounding the use of Kirschner wires, surgeons have started to use implantable fixation devices. 3,6,[8][9][10][11][12][13][14][15][16][17] These devices are implanted into the intramedullary canal of the proximal and intermediate phalanges holding the two bones firmly together until union is achieved. Their main advantage lies with the fact that patients can get back to normal activity, footwear, and bathing much quicker than with a percutaneous device.…”

“…Their main advantage lies with the fact that patients can get back to normal activity, footwear, and bathing much quicker than with a percutaneous device. 3,6,[8][9][10][11][12][13][14][15][16] This improves convenience, compliance, and patient satisfaction. It also cuts down on time-consuming additional review appointments required for wire removal.…”