title: Hammertoe Correction With K-Wire Fixation Compared With Percutaneous Correction.
abstract: BACKGROUND
  Kirschner wire (K-wire) fixation for correction of hammertoe deformity is the gold standard for hammertoe surgery fixation, the current study compares it to percutaneous surgery with 3M Coban dressings.
  
  
  METHODS
  All hammertoe corrections performed were retrospectively reviewed. For the K-wire fixation group: resection arthroplasty of the proximal interphalangeal joint was performed and fixed with a K-wire. The percutaneous technique used involved percutaneous diaphyseal osteotomy of the middle and proximal phalanges combined with tendon release. The toes are then wrapped in 3M Coban dressing for 3 weeks. Follow-up duration, preoperative diagnosis, pin duration, concomitant procedures, visual analogue scale (VAS) pain, recurrence rates, and complications were reviewed and analyzed. A total of 352 patients (87 percutaneous/265 open), in whom 675 hammertoes (221 percutaneous/454 open) were corrected. There were 55.9% females, with an average age of 52.8 years, followed for 6 months. The percutaneous group had more diabetics and multiple toes surgery.
  
  
  RESULTS
  Complications of the open surgery group included 5.5% pin migrations, 4.5% infections, and 8 (3%) had impaired wound healing. There were 6.2% recurrent deformities and 2.6% toes were revised. Malalignment was noted in 3.3% toes. Vascular compromise occurred in 0.5%, with 0.25% amputated. Complications of the percutaneous surgery group included 18.4% cases of impaired healing and 2.3% infection. Deep tissue dehiscence occurred in 4.5% of open surgery patients. VAS score decreased in both groups with a more pronounced decline in the percutanteous group (2 ± 2.1 vs 0.5 ± 1.6). The per toe infection rate of patients undergoing open hammertoe correction was 5.3% was significantly higher than with the percutaneous correction group, which was 2.2%.
  
  
  CONCLUSIONS
  K-wire fixation and percutaneous surgery have similar abnormal healing rates, alignment and patient satisfaction but the latter technique has fewer infections.
  
  
  METHODS
  Level III: Prospective case series with noncontamporenous cohorts.
authors.affiliation: Department of Orthopaedic Surgery, Sackler School of Medicine, Tel Aviv University, Petah Tikwa, Israel (MY, AG, EH).|Orthopedic Research Unit and Foot and Ankle Service, Hasharon Hospital, Rabin Medical Center, Petah Tikwa, Israel (DR).
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yassin
authors.affiliation: Department of Orthopaedic Surgery, Sackler School of Medicine, Tel Aviv University, Petah Tikwa, Israel (MY, AG, EH).|Orthopedic Research Unit and Foot and Ankle Service, Hasharon Hospital, Rabin Medical Center, Petah Tikwa, Israel (DR).
authors.forename: Avraham
authors.initials: A
authors.lastname: Garti
authors.affiliation: Department of Orthopaedic Surgery, Sackler School of Medicine, Tel Aviv University, Petah Tikwa, Israel (MY, AG, EH).|Orthopedic Research Unit and Foot and Ankle Service, Hasharon Hospital, Rabin Medical Center, Petah Tikwa, Israel (DR).
authors.forename: Eyal
authors.initials: E
authors.lastname: Heller
authors.affiliation: Department of Orthopaedic Surgery, Sackler School of Medicine, Tel Aviv University, Petah Tikwa, Israel (MY, AG, EH).|Orthopedic Research Unit and Foot and Ankle Service, Hasharon Hospital, Rabin Medical Center, Petah Tikwa, Israel (DR).
authors.forename: Dror
authors.initials: D
authors.lastname: Robinson
mesh_terms: D000328:Adult; D000368:Aged; D001458:Bandages; D001864:Bone Wires; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D037801:Hammer Toe Syndrome / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D008985:Monensin / Q000494:pharmacology; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods; D010027:Osteotomy / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D008985:Monensin
keywords: Coban dressing; claw toe; hammertoe; lesser toe deformity; percutaneous osteotomy