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Comparative Study of Intramedullary Hammertoe Fixation.

Caterina Obrador1, Marta Losa-Iglesias2, Ricardo Becerro-de-Bengoa-Vallejo3

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Summary

New intramedullary implants for hammertoe correction offer comparable outcomes to Kirschner wires (K-wires) but with higher patient satisfaction. Despite higher costs and some implant breakage, these implants provide good alignment and pain reduction.

Keywords:
K-wireSmart ToeTenFusearthrodesishammertoeintramedullary implantproximal interphalangeal (PIP) joint

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Area of Science:

  • Orthopedic surgery
  • Podiatric surgery
  • Biomedical engineering

Background:

  • Temporary Kirschner wire fixation (K-wire) is a common, low-cost method for hammertoe correction.
  • Complications with K-wires have driven the development of new implants.
  • Limited comparative studies exist on functional outcomes of different hammertoe fixation methods.

Purpose of the Study:

  • To analyze functional outcomes of proximal interphalangeal joint fusion using Smart Toe and TenFuse intramedullary implants.
  • To compare these outcomes with traditional K-wire fixation.
  • To evaluate complications and fusion rates for each fixation method.

Main Methods:

  • Retrospective review of 96 patients (186 toes) undergoing hammertoe correction.
  • Comparison of K-wire (65 toes), Smart Toe (94 toes), and TenFuse (27 toes) fixation.
  • Assessment using Foot Function Index (FFI), SF-36, and visual analog scale (VAS) questionnaires.
  • Evaluation of complication rates and fusion success.

Main Results:

  • No significant differences in functional outcomes or complication rates among the three fixation groups.
  • Intramedullary implants showed higher fusion rates and patient satisfaction.
  • Smart Toe implants had a significantly higher breakage rate (10.6%) within the first year.
  • SF-36 and VAS scores showed no significant differences at 12 months post-surgery.

Conclusions:

  • Smart Toe and TenFuse implants offer comparable outcomes to K-wires, with slightly improved patient satisfaction.
  • These implants are a reasonable choice for hammertoe correction, providing good alignment, pain reduction, and function.
  • Higher costs necessitate cost-benefit analyses before widespread adoption.
  • Further research is needed to justify the routine use of these newer implants over K-wires.