New Implant Offers Viable Alternative For Hammertoe Surgery

   For podiatric surgeons looking to reduce complications, improve outcomes and facilitate less postoperative pain for patients, a new implant may prove to be more beneficial than K-wire fixation in correcting hammertoe deformities.

   One may use the Smart Toe™ memory implant to help correct hammertoe deformities in toes two through five, according to MMI-USA, the manufacturer of the implant. The Smart Toe offers an implant comprised of a special alloy with shape memory properties called NiTinol. The company notes that these properties resist potential rotation of the device. MMI adds that the one-piece design of the implant facilitates precise placement.

   The unique qualities of the device help reduce the risk of complications, according to Arush Angirasa, DPM, who has performed close to 50 hammertoe procedures with the Smart Toe implant. Dr. Angirasa is currently in the midst of a study that compares the Smart Toe implant versus K-wire fixation for hammertoe correction via the end-to-end arthrodesis for the proximal interphalangeal joint of the respective digit. He says the preliminary findings are intriguing.

    “The Smart Toe implant had significantly less complications postoperatively compared to the K-wire method,” points out Dr. Angirasa, who is in private practice in San Antonio, Texas. “Patients with the implant experienced significantly less pain during their postoperative course and those with the implant achieved the desired end-to-end arthrodesis more quickly than with the K-wire technique, which, in fact, failed to provide arthrodesis in half of the study patients.”

   Dr. Angirasa says it has always been difficult to achieve arthrodesis with K-wire fixation. He cites a lack of compression and allowance for rotational moments within the fixation site.

    “The Smart Toe implant solves these two problems and has the advantage of being internally located, unlike the K-wire, which requires eventual removal,” emphasizes Dr. Angirasa.

   In the aforementioned study, Dr. Angirasa says there was a 100 percent success rate in achieving arthrodesis with the Smart Toe implant.

    “This is likely due to the design of the implant, which allows for constant compression, rigid internal fixation and resistance to rotation,” notes Dr. Angirasa.

   Dr. Angirasa adds that patients have praise for the Smart Toe implant as well. He notes that patients always feared the K-wire exiting out of their toe and had subsequent apprehension about removal of the K-wire in the clinic. The wireless approach seems to have gone over well with patients who have received the Smart Toe implant.

    “Patients are much more pleased with the lack of the external wire and, more importantly, are much more pleased with the overall result,” adds Dr. Angirasa.