Hammertoes Corrected by New Bone-Fusing Implant

Painful hammertoes, often caused by poor-fitting shoes that bend the second, third or fourth toe into an upside-down V at the middle joint, have usually been corrected by inserting a wire through the length of the toe, holding the toe bones in position so they can fuse together.

Trouble is, the so-called “K-wire” must protrude from the tip of the toe during the four to six weeks of healing that’s required, causing great discomfort and awkwardness, and elevating the chances for infection.

Now, however, a new treatment has been developed using one of a number of shape-memory alloys. When cool, these alloys can be deformed into any shape imaginable, but when they’re warmed up, they return to their original shape. The metal used in hammertoe treatment is NiTinol, an alloy of nickel and titanium. In its warm condition, it’s fashioned into the shape necessary to promote hammertoe bone fusion. Then it’s cooled, shaped for proper insertion, and introduced into the toe. The body’s warmth causes it to revert to its bone-fusion-promoting shape.

The new treatment can be applied not only to hammertoes but to other forms of deviated or crooked toes, such as mallet toes, claw toes and Morton’s toe, as well as to toe malformation caused by severe arthritis, diabetes, stroke or even heredity.

“I was looking for a better method for fusing the toe joints – one that would allow for stability without the use of external wires,” said Stuart Mogul, a New York City podiatrist. “To date, patient satisfaction has been high.”

Arush Angirasa, a podiatrist in San Antonio, Texas, performed a study in which he followed 30 patients for 56 weeks, comparing the NiTinol implant with K-wire usage. His results were similar to Mogul’s. “Most people,” Angirasa said, “are quite apprehensive about having an external wire protruding from their toe after the surgery, which then has to be removed.”

Mogul, who does a great deal of cosmetic surgery, also finds the implant easy to use. “It permits easy and precise placement in the toes and does not interfere with viable joints.”