Don't get me wrong, I admire those whom have adopted the latest procedures in correcting patients pedal digital maladies.
However, of late, I have observed a few patients with toe implants following hammertoe surgical correction that have resulted in rigid medial or lateral deviations. These deviations at the PIP joint are now in a fixed position, and the toe is well healed. However, the patient complains of impingement upon the adjacent toe. That is, they are suffering abrasions, callouses, if not blistering, and of course pain.
The other problem I observed in another patient recently was a long 2nd toe (with an implant) relative to the hallux and much longer relative to "curly toes" 3-4-5. It did not look right at all, and while the patient seemed to walk without difficulty on gait exam, the parabola was incorrect.
I still subscribe to the traditional K-wire fixation, that is removable, as I prefer to NOT leave anything behind. This is a school of thought that is shared by many a foot surgeon.
Anyhow, my question is, because obviously I never graduated to this advanced level of toe implant surgery, despite having attended the lectures and even the workshops at various conferences throughout the 2000's is this: HOW IS THIS RIGID, FIXED MEDIAL OR LATERAL DEVIATION REVERSIBLE?
One solution I have seen by an expert advanced implant and other technological applications in surgery podiatric foot surgeon was this: whenever the patient returns to clinic with the same repeat complaint was to dispense a couple of those nifty little foam toe web space dual colored (orange - yellow) pads with some paper tape.
Now, the patient is married to applying this pad everyday as part of their morning routine lest they incur lesion and pain. Plus, it is visible when they wear sandals or slippers.
Anyone's expert thoughts would be appreciated here...