DePuy Synthes Hammertoe Continuous Compression Implant
Hammertoe deformities are one of the most frequent deformities treated by foot and ankle surgeons. In rigid and structured hammertoe deformities not suited for nonoperative management, arthrodesis of the proximal interphalangeal (PIP) joint represents the standard treatment. Temporary K-wire fixation is the most frequently used, low-cost fixation method for PIP joint fusion. However, reported complications associated with K-wires have prompted the development of new implants over the past decade. To address weaknesses of intramedullary fixation concepts (eg, limited rotational stability), the Foot and Ankle Expert Group approved the first extramedullary continuous compression implant (CCI) to treat hammertoe deformities – the DePuy Synthes Hammertoe Continuous Compression Implant (DPS Hammertoe CCI).
The DPS Hammertoe CCI has a staple-like design with four legs and a low profile connecting bridge (Fig 1). It is made of biocompatible Nitinol, a metal alloy of nickel and titanium, which is known for its superelastic properties and shape memory behavior.
The implant system is delivered to the operating room in a disposable, sterile kit containing the Insertion Stick with the pre-loaded implant (Fig 2) and other instruments needed for the implantation procedure (Fig 3).
Once the DPS Hammertoe CCI is inserted into the bone and released from the Insertion Stick, the implant attempts to regain its original shape with converging legs thereby providing active continuous compression at the fusion site (Fig 4). The design with the four legs orthogonal to the bone axis and the active compression feature are beneficial for the distraction resistance (Fig 5).
The implant is not supposed to be reused after it has been discharged from the Insertion Stick because any processing, reprocessing, or mechanical manipulation may reduce the effectiveness of the implant.
So far, the DePuy Synthes Hammertoe CCI System is only available in the United States. However, it is under consideration for introduction to other regions of the world.
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