The two-pin arthrodesis technique for proximal interphalangeal joint fusion of the lesser toes

Abstract

Arthrodesis of the proximal interphalangeal (PIP) joints of the lesser toes is a commonly performed procedure for correction of the claw toe and hammer toe deformity. Multiple techniques of fixation have been described to achieve a solid fusion with variable fusion rates (Coughlin and Polk in Operative repair of the fixed hammertoe deformity. Foot Ankle Int 21(2):94–104, 2000). The standard technique for many years uses a single intramedullary K-wire (Baig and Geary in Fusion rate and patient satisfaction in proximal interphalangeal joint fusion of the minor toes using Kirschner wire fixation. The Foot 6:120–121, 1996 ). We present our technique of fusing the PIP joint with two fine K-wires, used to prevent rotational displacement and ensure sound arthrodesis. Our series of 36 fusions in 25 patients were assessed independently using the American College of foot and ankle surgeons score (ACFAS) and the Foot Function Scale (FFS). A fusion rate of 97% was achieved with 89% of patients were satisfied with the appearance of their toes. There was a significant reduction in pain levels with 90% of patients reporting no pain with normal activities. We believe our simple improvement to the single wire technique results in superior outcomes.