Intramedullary Fixation System for the Treatment of Hammertoe Deformity

Hammertoe is one of the most common foot deformities. Arthrodesis or arthroplasty of the proximal interphalangeal joint using temporary Kirschner wire fixation is the most widespread method of surgical stabilization. However, this type of fixation is associated with some potential complications that can be obviated if percutaneous fixation is avoided. The purpose of the present study was to prospectively collect clinical and radiographic outcomes of operative correction of hammertoe deformity using a permanently implanted 1-piece intramedullary device. A total of 29 patients with 60 painful, rigid hammertoes were prospectively enrolled, clinically and radiographically examined, operatively treated, then followed and re-examined. The outcomes were measured in terms of the American Orthopaedic Foot and Ankle Society lesser toe and visual analog pain scores. After ≥18 months of follow-up, the incidence of fusion with satisfactory radiographic alignment was 85% (51 of 60 toes). One toe (1.67%) developed early postoperative implant failure because of dislocation of the device, there were no cases of infection, and the mean American Orthopaedic Foot and Ankle Society lesser toe score was 87.4 ± 1.3 and the mean visual analog scale pain score was 1.78 ± 0.94. Twenty-five patients (86.21%) stated that they had no symptoms in the involved toes after surgery, and 4 (13.8%) experienced occasional pain, 2 (6.9%) of whom reported limitations of recreational activities and 2 (6.9%) reported persistent swelling without activity limitations. All the patients stated that they would undergo the surgery again if they had the same preoperative condition.