"Pilot Hole" Technique for Interphalangeal Joint Fusion of Toes

Fusion of an interphalangeal joint of a lesser toe is a commonly used procedure for addressing interphalangeal joint deformities such as a hammer or a claw toe. Fusion can be achieved by insertion of an intramedullary Kirschner wire in a retrograde manner. Deviation of the Kirschner wire from the intramedullary canal into the surrounding soft tissues is common. This can render the fusion unstable and can cause painful soft-tissue irritation and early Kirschner wire loosening, resulting in an unstable nonunion with recurrence of deformity. We describe a simple and reproducible technique to assist with optimal intramedullary placement of the Kirschner wire, thereby reducing the risk of complications after interphalangeal joint fusion of a toe.