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Home/Large Joints and Extremities/84% Fusion Rate vs 16% – New JFAS Hammertoe Study
Large Joints and Extremities

84% Fusion Rate vs 16% – New JFAS Hammertoe Study

June 2, 2016 1 min read Premium comments

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84% Fusion Rate vs 16% – New JFAS Hammertoe Study
Kamran Jamshidinia, MD doing Hammertoe Surgery / Source: Wikimedia Commons and Bestlin Plastics
Secondary

A new study published in The Journal of Foot and Ankle Surgery, “Dual-Component Intramedullary Implant Versus Kirchner Wire for Proximal Interphalangeal Joint Fusion: A Randomized Controlled Clinical Trial, ” compared using the Nextra implant to K-wires. Nextra crushed K-wires in terms of fusion rates.

The study, which was a randomized treatment group vs control group trial, found clear advantages to the Nextra Hammertoe Correction System to treat hammertoe deformity. K-wires are considered to be the traditional treatment for Hammertoe correction.

Nextra is a two-piece implant developed by Nextremity Solutions, Inc., located in Warsaw, Indiana. In the study it achieved a five times higher rate of bone fusion than did the K-wires—84% fusion rate with Nextra versus 16% with K-wires.

Mike Coon, Executive Director of Sales & Marketing for Nextremity Solutions, Inc., said, “Some of the issues with the utilization of K-wires in hammertoe surgery are a lack of fusion, lack of rotational stability, risk of infection with post-operative K-Wire exposure, and poor patient satisfaction. According to the study, patients with the Nextra implant not only had drastic improvements in fusion rates but also experienced greater pain relief, a decrease in disability and an increase in activity levels.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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