Clinical Results of Bio-Integrative Fiber-Reinforced Implants for Hammertoe Correction: A Review of Surgical Outcomes

T JimEnez, T Wingo, H Ubillus, R Walls

Introduction: Hammertoe deformity, which constitutes nearly half of all forefoot surgeries, has traditionally been corrected using Kirschner wire (K-wire) fixation. However, K-wires are associated with various complications. Intramedullary implants offer better pain control, higher union rates, and lower infection risks. OSSIOfiber implants, made from reinforcing mineral fibers and a bioabsorbable polymer matrix, are a novel alternative. This study evaluates
the radiological and clinical outcomes of OSSIOfiber implants for hammertoe correction.

Methods: A retrospective cohort study was conducted at a large urban academic medical center from January 2022 to December 2023. Patients with hammertoe deformities who underwent surgery using OSSIOfiber implants were assessed. Clinical outcomes were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS), and radiographic imaging was used to evaluate union rates. Data on patient characteristics and
postoperative complications were collected.

Results: The study included 11 patients with 21 operative toes, with a mean follow-up of 5.7 months. Deformity correction was maintained clinically and radiologically in 81% of toes. Significant improvements were noted in PROMIS domains: Physical Function, Pain Interference, and Pain Intensity. The successful union rate was 81%. However, the complication rate was 52.3%, with 19% requiring re-intervention due to painful malunion or non-union, and 23.8% of cases converting to K-wire fixation.

Conclusion: The OSSIOfiber implant showed promising clinical and radiological outcomes for hammertoe correction. Despite its effectiveness, the high complication rate and need for potential conversion to K-wire fixation emphasize the importance of pre-operative planning. Further long-term studies are needed to confirm its reliability as an alternative for joint fusion in lesser toes.