Name: Proximal Interphalangeal Fusion For Claw & Hammertoe Deformity Using The Trim-It Spin Pin™
Uploaded: 2008-01-23T00:00:00Z
Channel: Arthrex

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DVD-1098 | A | Proximal Interphalangeal Fusion For Claw & Hammertoe Deformity Using The Trim-It Spin Pin™

Gerard Bourke

Human

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Proximal Interphalangeal Fusion For Claw & Hammertoe Deformity Using The Trim-It Spin Pin™

The following program demonstrates a proximal interphalangeal fusion utilizing the TRIM-IT spin pin for fixation. Proximal interphalangeal fusion for claw and hammertoe deformities can now be surgically addressed in a simplified technique that obviates the pitfalls encountered with traditional percutaneous K-wires methods. In this demonstration, the Arthrex TRIM-IT spin pin is utilized to conduct claw and hammer toe correction. Simply, quickly, and with reproducible results, the TRIM-IT spin pin is a bioabsorbable PLL pin with a stainless steel tip. This allows the pin to be drilled directly into the bone, utilizing a similar technique as previously used with the percutaneous wire. A notch placed on the PLL shaft allows the pin to be snapped off at precisely the correct position to hold the reduced pip joint without leaving pin material crossing the dip joint. The result is solid fixation without the inconvenience and hazard of a protruding percutaneous pin without the protruding wire. The patient has markedly decreased morbidity and inconvenience with a concomitant decreased risk of infection. It allows normal foot covering and mobilization of the MTP joint and the Dip joint. There is increased patient satisfaction in Cosmesis, and the increased duration of fixation will prevent late deformity and increase the rate of fusion. The absorbable pin can be molded following insertion, which also allows more anatomical shaping of the Toe to provide a more functional and cosmetically pleasing result. The procedure is simple and easy to perform with a short learning curve, because it mimics current techniques utilizing the metal wire. Surgeons will very quickly adapt to the use of the absorbable pin. It is also much safer due to the absence of absence of exposed wires during the procedure. The TRIM-IT spin pin comes with a metal pre-drill for hard bone stock and fits standard wire drivers, making it very user friendly in surgery. The implant is fully bioabsorbable and the plla has proven to be safe and effective, with almost no risk of implant reaction. The operation may be performed under general or local anesthesia, with or without a tourniquet. Transverse or longitudinal incisions may be employed to expose the proximal interphalangeal joint, and the extensor hood is excised. The collateral ligaments are divided to expose the head of the proximal phalanx in the base of the middle phalanx. These are excised utilizing a sagittal saw or rongeur. The spin pin is then loaded into the K-wires driver with the metallic end protruding. The pin is then used to make a pilot hole in the proximal phalanx, utilizing the laser etched markings to determine the length of the of the proximal hole. The pin is then introduced into the middle phalanx until resistance is encountered. This represents the length of the middle phalanx and is added to the previously measured proximal phalanx to give the desired length. For final insertion, the metallic end is continued across the distal interphalangeal joint and out of the tip of the toe. The desired length is measured from the prefabricated notch of the spin pin in the direction of the bioabsorbable tip. At the desired measurement, the pin is cut. This leaves the desired length from the prefabricated notch to the tip of the pin. The pin is then withdrawn from the tip of the toe, allowing the cut end to be placed into the pilot hole. In the proximal phalanx, the joint is reduced as the pin is passed down the length of the proximal phalanx. When resistance is encountered, the supplied forceps are introduced into the proximal interphalangeal joint, grasping the pin with the wire driver still spinning. The pin is grasped and the PLA portion will break at the prefabricated notch, which is now located at the distal end of the middle phalanx. The metallic end is now withdrawn, leaving the absorbable pin along the exact length of the proximal and distal phalanx. Holding the pip joint in a reduced position, final seating can occur with gentle axial pressure to close the arthrodesis site. Final anatomical shaping may then be performed if desired, and the wound is sutured. As can be seen, the procedure is simple and produces effective fixation of the proximal interphalangeal joint without all of the disadvantages of percutaneous K-wires. The technique mimics that utilized by many surgeons, and the instruments are compact and user friendly. The decreased risk and increased patient satisfaction makes the use of a bioabsorbable Pin in the treatment of claw toes extremely desirable, with improved outcomes in comparison to traditional techniques performed using a percutaneous K-wires have many disadvantages, including. The joint must be held in a reduced position for six weeks, after which the K-wires are removed. K-wires can be a source of infection, especially in diabetics or patients with borderline vascular supply. The protruding metal wire can catch on bedclothes and clothing, and precludes a return to normal footwear, requiring the patient to wear a post-operative shoe until the wires are removed. Usually, a protective device is added to the tips of the wire, which adds expense in bulk. K-wires also prevents the ability to perform immediate therapy to help mobilize the toes and edema control, and if the Pip joint is not fuzed when the wire is removed at six weeks late, deformity can occur. The TRIM-IT spin pin offers an advanced alternative to proximal interphalangeal fusion for klon hammertoe deformities. Through a simplified, reproducible approach.

Procedure

Arthrodese des Interphalangealgelenks

Proximal Interphalangeal Fusion For Claw & Hammertoe Deformity Using The Trim-It Spin Pin™

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