Two-Piece Hammertoe Implant Offers Easier Insertion

An emerging hammertoe implant may provide strong correction and interphalangeal stabilization with less trauma to tissues.

The opti-Toe^®, part of a new generation of cannulated implants, is composed of titanium and offers ease of insertion, according to the manufacturer GraMedica. The company adds that the opti-Toe is a two-piece unit with pieces that connect at the final union, which the surgeon can confirm with a click. As GraMedica says, the implant stabilizes the joint by locking the middle phalangeal component into the proximal phalangeal component’s chamber.

The modularity of the implant is an advantage over one-piece implants for Elie Daniel, DPM, the CEO of Cedars Surgical in Mendota, Ill. If one part of the implant does not work, he says the opti-Toe’s modular nature permits surgeons to replace that part. To take apart the implant, the company says the surgeon would use the top of Adson forceps to place pressure on the small notch that forms when the two parts snap together.

The two-piece nature of the opti-Toe is in contrast to other hammertoe implants of newer designs, which consist of one long piece, notes GraMedica. As the company says, one-piece implants require a “bayonet type” insertion technique, which can result in more intraoperative trauma to patients’ tissues.

With the opti-Toe implant, GraMedica says surgeons can perform atraumatic bone preparation and avoid the complication of thermal osteonecrosis. After resecting the bone, the surgeon can use Adson forceps to create a chamber in the middle phalanx and into the head of the proximal phalanx, and ensure deep enough depth for optimal fit of the implant, according to GraMedica. The company adds that the opti-Toe is simple to use, which facilitates a shorter operative time.

The company says the implant comes in several sizes along with the option of a 10-degree angle for fixation. GraMedica adds that the implant is also compatible with 0.045 or 0.062-inch K-wire fixation if necessary.

Dr. Daniel has used the opti-Toe for the last year or two, and says it is “very successful.” He notes patients have expressed postoperative satisfaction and like the way the corrected toe looks. One recent patient has received several opti-Toes with success, notes Dr. Daniel, who is affiliated with the Podiatric Surgery Department of OSF St. Paul Medical Center in Peoria, Ill.

Podiatrists should also emphasize protected weightbearing postoperatively until healing has occurred, according to the company.

For further reading, see “When Hammertoe Surgery Fails” in the October 2018 issue of Podiatry Today, “Current Concepts In Hammertoe Correction” in the September 2015 issue or “Emerging Concepts In Hammertoe Surgery” in the September 2009 issue.