Cover Journal of the American Podiatric Medical Association
Journal of the American Podiatric Medical Association
ISSN:
8750-7315
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Article Type:
Clinically Illustrated
Online Publication Date:
Jul 2016

“Pilot Hole” Technique for Interphalangeal Joint Fusion of Toes

Nikhil Sharma Department of Trauma and Orthopaedics, The Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton, England.

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 MRCSEd, MBChB, PGCert, AFHEA
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David Morley Department of Trauma and Orthopaedics, The Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton, England.

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Dev Damany Department of Trauma and Orthopaedics, The Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton, England.

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 MBBS, FRCS
DOI:
https://doi.org/10.7547/15-008
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Fusion of an interphalangeal joint of a lesser toe is a commonly used procedure for addressing interphalangeal joint deformities such as a hammer or a claw toe. Fusion can be achieved by insertion of an intramedullary Kirschner wire in a retrograde manner. Deviation of the Kirschner wire from the intramedullary canal into the surrounding soft tissues is common. This can render the fusion unstable and can cause painful soft-tissue irritation and early Kirschner wire loosening, resulting in an unstable nonunion with recurrence of deformity. We describe a simple and reproducible technique to assist with optimal intramedullary placement of the Kirschner wire, thereby reducing the risk of complications after interphalangeal joint fusion of a toe.

Corresponding author: Nikhil Sharma, MRCSEd, PGCert Med Ed, AFHEA, Department of Trauma and Orthopaedics, The Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton Road, Wolverhampton WV10 0QP, United Kingdom. (E-mail: n-sharma@doctors.org.uk)
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