Our Summary

This research paper explores a common method used in treating deformities in the smaller toes, such as hammer or claw toe. This method involves fusing the joint of the affected toe, which is usually done by inserting a wire into the bone marrow canal of the toe. However, the wire can often shift from the canal into the surrounding soft tissues, which can cause the joint fusion to become unstable, lead to painful irritation, and possibly cause the wire to loosen early. This can result in the deformity returning. The paper suggests a new and reliable technique to ensure the wire is placed correctly in the bone marrow canal, which could reduce the risk of these complications following the toe joint fusion procedure.

FAQs

  1. What is the purpose of a fusion of an interphalangeal joint of a lesser toe?
  2. What complications can arise from deviation of the Kirschner wire from the intramedullary canal into the surrounding soft tissues?
  3. How does the technique described assist with optimal intramedullary placement of the Kirschner wire?

Doctor’s Tip

A doctor may advise a patient undergoing joint fusion to follow post-operative instructions carefully, including keeping weight off the fused joint and avoiding strenuous activities that could put excessive stress on the fusion site. It is important to attend follow-up appointments and physical therapy sessions to ensure proper healing and rehabilitation of the joint. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support overall joint health and prevent future joint issues.

Suitable For

Patients who are typically recommended joint fusion include those with severe joint deformities, such as hammer or claw toes, that are causing pain, instability, or difficulty with walking. Joint fusion may be recommended when other conservative treatments have failed to provide relief. Patients with conditions such as arthritis, trauma, or congenital deformities may also benefit from joint fusion surgery. Additionally, patients who have undergone previous unsuccessful surgeries or have chronic joint instability may be candidates for joint fusion.

Timeline

Before joint fusion:

  1. Patient experiences pain and deformity in the affected toe joint, such as a hammer or claw toe.
  2. Patient consults with a healthcare provider who recommends joint fusion as a treatment option.
  3. Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for joint fusion.
  4. Surgical date is scheduled and patient is informed about the procedure, risks, and expected outcomes.

After joint fusion:

  1. Patient undergoes the joint fusion procedure, which involves insertion of an intramedullary Kirschner wire in a retrograde manner.
  2. Post-operative care includes pain management, wound care, and physical therapy to aid in rehabilitation.
  3. Patient follows up with their healthcare provider for regular check-ups and monitoring of the fusion site.
  4. Over time, the fusion site heals and the toe joint becomes stabilized, reducing pain and deformity.
  5. Patient may experience improved function and mobility in the affected toe joint, leading to an overall improvement in quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with joint fusion surgery?
  2. How long is the recovery period and what can I expect during the healing process?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What type of anesthesia will be used during the procedure and what are the potential side effects?
  5. How successful is joint fusion surgery in relieving pain and improving function in the affected joint?
  6. Are there any alternative treatments or procedures that I should consider before opting for joint fusion?
  7. How soon after the surgery will I be able to return to normal activities, such as walking or exercising?
  8. Will I need to have the fusion hardware removed at a later date, or is it meant to remain in place permanently?
  9. What steps can I take to ensure the best possible outcome and minimize the risk of complications following joint fusion surgery?
  10. How often will I need follow-up appointments to monitor the healing process and check for any signs of complications?

Reference

Authors: Sharma N, Morley D, Damany D. Journal: J Am Podiatr Med Assoc. 2016 Jul;106(4):305-7. doi: 10.7547/15-008. PMID: 27489973