Digital "V" arthrodesis.

Abstract

Numerous procedures have been proposed through the years for the treatment of digital hammertoes and other related structural deformities. Experience has determined that many of these procedures are structurally incorrect and result in secondary deformity, which are often worse than the pathology initially addressed. Phalangeal base resections were found to destroy the structural stability provided by the intrinsic musculature. Phalangeal head resections make the toe impressionable to the extrinsic forces of the adjacent toes often leading to structural mal-alignment, or additional contracture. Similarly, indiscriminate tendon lengthenings have led to flail toes and a lack of purchase and propulsion. The advent of proximal interphalangeal joint arthrodesis demonstrated that structural stability and propulsion could be maintained while enhancing alignment. The "V" arthrodesis, as introduced by the authors, provides an alternative surgical approach to digital fusions. This approach is technically less difficult compared with a peg-in-hole fusion and provides enhanced stability when compared with an end-to-end arthrodesis. The preliminary results of this procedure appear to be most promising and are provided to the readership for review and examination.