Treatment of hammertoe deformity using a one-piece intramedullary device: a case series

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. In the present series of 7 toes in 3 patients, we describe an alternative method of hammertoe fixation using a permanently implanted, 1-piece intramedullary device used to stabilize the proximal interphalangeal interface. The potential advantages of this prosthesis include elimination of wire migration and breakage, enhanced control and stability of the digit, elimination of potential pin tract infection, and decreased patient anxiety since hardware removal is not required. The patients were followed up for approximately 1 year after the surgery, and no intraoperative or postoperative complications were observed. The implant maintained proper clinical and radiographic alignment throughout the observation period, without implant failure or breakage. All patients were satisfied with the cosmetic appearance of their surgically corrected toes and were able to perform all activities of daily living without the use of assistive devices. Also, their postoperative pain and function were acceptable. The implant used in the patients described in the present report appears to be a viable alternative for the treatment of hammertoe.