ARTHRODESIS OF INTER-PHALANGEAL JOINTS OF LESSER TOES USING CANNULATED SCREW: A REPORT OF 21 CASES

Abstract

Inter-phalangeal (IP) joint fusion of lesser toes has been quite a commonly done procedure using Kirchner wires (K-wire). Infection from the K-wire site has been significant complication. We present a retrospective study of 21 toes of arthrodesis of IP joints of lesser toes using a cannulated screw.

The indications were either claw toe or a hammer toe. All the cases that were done from February 2006 to June 2008 were included. There were 21 toes in 15 patients at an average age of 69 years (range 54 – 80). There were 20 females and only one male. The distribution of second, third and fourth toes were 12, 6 and 3 respectively. Nine toes were right sided and 12 were left sided. They were followed for an average of 14 months (range 2–30).

There was one case of superficial cellulitis (4.8%) which has responded well to antibiotic therapy. There were two cases where the prominent screws had to be removed at 4 and 5 months post-operative period. Good arthrodesis has been achieved by this time.

Clinical arthrodesis was achieved at 4.5 months (range 3–7) and radiological arthrodesis was achieved at 5.2 months (range 4 – 9). All have been discharged at the time of this study.

Good correction of deformities with well healed arthrodesis was achieved. Most patients reported pain free toes. We have found this technique to be very useful alternative with good results and less complications.