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Lesser Proximal Interphalangeal Joint Arthrodesis

A Retrospective Analysis of the Peg-in-Hole and End-to-End Procedures

Bradley M. Lamm Submitted during fourth year, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Carla E. Ribeiro Submitted during fourth year, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Tracey C. Vlahovic Submitted during fourth year, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Anthony Fiorilli Submitted during second year, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Gary R. Bauer Associate Professor, Department of Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Howard J. Hillstrom Associate Professor, Department of Orthopedics and Biomechanics, Director, Gait Study Center, Temple University School of Podiatric Medicine. Mailing address: Eighth at Race St, Philadelphia, PA 19107.

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A retrospective study was performed to compare the prevalence of complications in peg-in-hole and end-to-end arthrodesis procedures. The authors reviewed 177 second, third, and fourth proximal interphalangeal joint fusions for the correction of hammer toe deformities in 85 patients from 1988 to 1998 at the Temple University School of Podiatric Medicine. The average age of the patients was 49 years. Sixteen percent (14) of the subjects were male and 84% were (71) female. Upon follow-up, the fourth digit was generally associated with a greater number of complications for the end-to-end and peg-in-hole procedures, with the second digit being the most common site of fusion. The prevalence of complications was evaluated using contingency table analysis and expressed as a percent of total complications (27%, the end-to-end group; 17%, the peg-in-hole group). A subset of complications deemed clinically relevant was also computed. Similarly, the prevalence of clinically relevant complications for the end-to-end (10%) and the peg-in-hole (9%) procedures was not statistically significant. Therefore, this study showed no statistically significant differences in the total or clinically relevant complications between end-to-end and the peg-in-hole arthrodesis procedures. (J Am Podiatr Med Assoc 91(7): 331-336, 2001)