Reduction of Dorsal Displacement of the Proximal and Middle Phalanges Using a Neutral or Angled Implant for Joint Arthrodesis to Treat Hammertoe Deformity A Finite Element Study

J Am Podiatr Med Assoc. 2015 Nov;105(6):493-502. doi: 10.7547/14-032.1.

Abstract

Background: We used finite element analysis to study the mechanical displacements at three planes of the second through fourth hammertoes during the push-off phase of gait using a new neutral or 10° angled memory alloy intramedullary implant (FDA K070598) used for proximal interphalangeal joint arthrodesis.

Methods: After geometric reconstruction of the foot skeleton from computed tomographic images of a 36-year-old man, an intramedullary implant was positioned in the virtual model at the neutral and 10° angled positions at the proximal interphalangeal joints of the second through fourth hammertoes during the push-off phase of gait. The obtained displacement results in three planes were compared with those derived from the nonsurgical foot model using finite element analysis.

Results: These results support the successful use of either a neutral or angled implant for proximal interphalangeal joint arthrodesis, with the neutral implant yielding slightly better results.

Conclusions: The neutral implant reduced vertical displacement to a greater extent than did the angled implant. We also highlight the potential risk of iatrogenic curly toe when performing a proximal interphalangeal joint arthrodesis using an angled implant specifically at the fourth toe.

MeSH terms

  • Adult
  • Arthrodesis / methods*
  • Finite Element Analysis
  • Hammer Toe Syndrome / diagnosis
  • Hammer Toe Syndrome / surgery*
  • Humans
  • Male
  • Prostheses and Implants*
  • Toe Joint / diagnostic imaging
  • Toe Joint / surgery*
  • Tomography, X-Ray Computed*