Smart Toe is a memory implant used in arthroplasty procedures to correct hammer toe, claw toe and mallet toe deformities. Available in the U.S. since 2007, the implant provides orthopedics and podiatric surgeons a new treatment option because it corrects the failure and implantation problems associated with K-wires and previous generations of implants, delivering highly positive outcomes with faster healing and few complications.
Video SmartToe
Hammer Toe Surgical Options
The goal of corrective hammer toe surgery is to straighten and align the afflicted toe, ensuring the bones fuse in the right position.
Different procedures to straighten the toe and allow for natural flexibility may involve cutting or re-aligning tendons, re-balancing muscle, and/or removing small portions of bone.
When bone is removed, the repaired bones may be:
- Temporarily fixed in place with a pin or K-wire during healing
- Fused together with screws or an implant
The most common device used in the surgical correction of hammer toes is the K-wire. After bone has been removed and the toe has been re-aligned, the wire is inserted through the open end of the afflicted toe to hold the joint in place and stabilize it. The wire stays in place for up to six weeks during the healing process. K-wires can be painful, uncomfortable and prone to infection. Because the wound is open, K-wires can lead to "pin tract" infection requiring additional treatment and further complicating the recovery period.
Another concern is that K-wires affect all the bones of the corrected toe (even if only the second and third joints require treatment).
Implants are an alternative to K-wires. Previous generation implants are two pieces that must be "coupled" during surgery. These can be awkward to connect and they also run the risk of disconnecting or even rotating in place, sometimes making a second surgery necessary.
In comparison to K-wires and other implant designs, the SmartToe implant is completely internal; stabilization does not require the use of an external wire as the toe heals. Its "memory" capability helps compress the joint into its proper shape, encouraging rapid fusion. Its one-piece design doesn't interfere with nearby healthy joints, and, it resists rotation problems common to other surgeries
Maps SmartToe
Technology
The SmartToe implant is constructed of nickel titanium (NiTi), a shape memory alloy also commonly referred to by the name, Nitinol. The material is highly biocompatible and has properties suitable for use in orthopedic implants.
SmartToe is the first hammer toe implant design to leverage Nitinol's heat-activated, compressive properties.
The implant is cooled prior to surgery, and once implanted, body heat expands its width and shortens its length. Expansion secures the implant in place, while the shortening pulls the bones tightly together to encourage the natural fusion process. These compressive features reduce healing time.
The shape of the SmartToe implant's flat, lateral design resists rotation, an important feature that maintains the correction. Rotation can occur with K-wire and other cylindrical implants. Unplanned rotation can complicate the healing and fusion of the bone.
Attributes
Orthopedic and podiatric surgeons using the SmartToe implant report that it helps prevent the issues associated with external pin fixation, or K-wires, and:
- Can reduce healing time due to its inherent compressive features
- Can reduce potential infection due to no post-op (after surgery) implant exposure
- Does not disrupt healthy joints
- Resists rotation
References
"Hammer Toe Surgical Correction, Arthrodesis of the Proximal Interphalangeal (PIP) Joint Using a New Shape Memory Intramedullary Implant," Marino Delmi, Foot & Ankle Centre, Clinique des Grangettes, 1224 Chêne-Bougeries/Geneva, CH-Switzerland
"New Intramedullary Implant for Proximal Interphalangeal Joint Arthrodesis;Techniques in Foot & Ankle Surgery"; Techniques in Foot & Ankle Surgery, 2008; Daniel J. Cuttia, DO, William DeCarbo, DPM, W. Bret Smith, DO, and Gregory C. Berlet, MD, Orthopedic Foot and Ankle Center, Columbus, Ohio.
"Top Innovations in Pediatric Care", Podiatry Today, August 2009, page 26.
"New Implant Offers Viable Alternative For Hammertoe Surgery", Podiatry Today, March 2009, page 90.
"Can A New Implant Lead To Easier Hammertoe Arthrodesis?", Podiatry Today, February 2008, page 134.
External links
- orthoinfo.aaos.org
- stryker foot & ankle
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Source of the article : Wikipedia
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