title: Intramedullary Fixation System for the Treatment of Hammertoe Deformity.
abstract: 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.
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy. Electronic address: attbasile@tiscali.it.
authors.forename: Attilio
authors.initials: A
authors.lastname: Basile
authors.affiliation: Departmento of Orthopaedics and Traumatology, Ospedale Padre Pio, Bracciano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Albo
authors.affiliation: Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Alessio Giai
authors.initials: AG
authors.lastname: Via
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D037801:Hammer Toe Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: PRO-TOE(®); digital deformity; phalanx; surgery; toe