Name: DynaNite® FlexWire and DynaNite PIP Implant for Hammertoe Correction
Uploaded: 2020-10-26T00:00:00Z
Channel: Arthrex
Description: James Cottom, DPM (Sarasota, FL), demonstrates a hammertoe correction using the DynaNite ® PIP implant in conjunction with the DynaNite FlexWire.

<p>James Cottom, DPM (Sarasota, FL), demonstrates a hammertoe correction using the DynaNite<sup>®</sup> PIP implant in conjunction with the DynaNite FlexWire.</p>

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VID1-001441-en-US | A | DynaNite® FlexWire and DynaNite PIP Implant for Hammertoe Correction

James Cottom

Human

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

Operationstechnikvideos

Surgical Technique Videos

Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

Vídeos de técnicas cirúrgicas

Grabación en vídeo de una técnica quirúrgica de un paciente en un quirófano o una demostración cadavérica.

Videos de técnicas quirúrgicas

DynaNite® FlexWire and DynaNite PIP Implant for Hammertoe Correction

So today we're going to go ahead and demonstrate the new nitinol DynaNite flex wire. So this is a two zone wire where two thirds of it will bend and always return to its straight or native configuration, and one third can be bent and cut for a standard hammer toe procedure. So with this particular wire, there's a laser mark at the end, which will be at the tip of the toe. So what we can do is check this under Fluoroscopic imaging to identify where we want the wire to end at the most proximal aspect inside the second metatarsal. So at this point we're going to go ahead and cut the wire where we marked it. So this is going to end at the most proximal aspect we marked in the second metatarsal. It's recommended to leave a little bevel on it. So when you cut it kind of cut it at an angle. So at this point standard dissection for a hammertoe repair has been performed. We removed the collateral ligaments and now we're ready for our bone prep. So now we're going to place a wire for our cup and cone reamers right down the central aspect of the head of the proximal phalanx. So now So now we're able to utilize the concave and convex reamers similar to the first metatarsophalangeal joint to prepare the fusion site in the second digit. So another unique feature with this is the end, if you will, is a three prong. So it's a little bit easier to introduce down to the articular surface on the head of the proximal phalanx. So now we're going to use the 3.0 drill bit for the DynaNite hammertoe implant. So at this point we are going to go ahead and retrograde the malleable end of the wire off the distal tip of the digit. So we'll identify the central aspect of the base of the middle phalanx. So now we're going to go ahead and use the convex end of the corresponding reamer to prep the base of the middle phalanx. So So now we're going to go ahead and utilize the 2.5mm drill to prepare the base of the middle phalanx. And we'll drill down to the laser line on the drill. So now we're going to insert the threaded portion of the DynaNite pip implant into the middle phalanx. So with this straight implant you want to make sure that the notch is actually facing upwards or dorsally to make sure that the implant is appropriately aligned. So after inserting the prongs into the proximal phalanx, we can go ahead then and tap distally to compress the joint together. So at this point we are going to advance the wire to expand the barbs in the proximal end of the implant across the second metatarsal phalangeal joint. And you want to insert this until the laser lines at the tip of the digit. Because the end of the wire distal is malleable. It can be bent in a standard fashion. So in addition, what's unique with this particular implant and wire is we can go ahead and we can actually move the MTP joint up and down. And with that flexible end of the wire, it's going to come back to its original position while still maintaining stability at the fusion site at the proximal interphalangeal joint. So when removing the wire in the clinic or we need to do is clamp it like we would normally do and just pull it straight out, and we will be able to see that this wire is straight as opposed to being bent, even though we manipulated the second metatarsophalangeal joint. And this will, of course, minimize the risk of having to remove bent or broken wires, which is a significant advantage in this particular procedure.

DynaNite® FlexWire and DynaNite PIP Implant for Hammertoe Correction

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