Peg-in-socket arthrodesis of the interphalangeal joints of the toes
Abstract
Background: Toe deformations are not uncommon, particularly among female patients. They can be operated on as an isolated or a combined procedure. There are various IP joint arthrodesis techniques. We present our experience with the “peg-in-socket” technique.
Methods: The rates of complications in the group treated with arthrodesis fixed with Kirschner pin
(KI group - 20 patients, 26 toes) and in the group treated with peg-in-socket technique (PEG group - 50 patients, 61 toes) were compared and evaluated with Chi-square test.
In the PEG group, the pain and activity improvement were evaluated with Z-test. Footwear limitations, success of bone arthrodesis, pain or callus relapse, toe form, position and orientation before and after the procedure are described.
Results: Early complications were more frequent in the KI group (p < 0.05).
In the PEG group, pain evaluation improved from 15.6 to 31.2 points (p < 0.01), activity limitations from 3.7 to 5.9 (p < 0.01). All patients continued to wear orthopaedic or comfortable shoes. Five of 50 patients had unsuccessful arthrodesis (1 pseudoarthrosis, 2 nonunions, 2 malunions). All patients had painful calluses before the procedure. Afterwards 9 were pain- and callus-free, the rest reported occasional minor residual pain. All patients had deformed toes preoperatively. After the peg-in-socket artrodesis, 9 toes outlooks were graded as excellent, 50 as good and 2 as bad.
Conclusion: The “peg-in-socket” arthrodesis is not the simplest technique. Jet it is a reliable, repeatable and inexpensive ambulatory procedure which uses patient’s structures without foreign materials.
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