{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:33:11Z","timestamp":1792801991369,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,10,20]],"date-time":"2018-10-20T00:00:00Z","timestamp":1539993600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lesser toe proximal interphalangeal (PIP) joint arthrodesis is one of the most common foot and ankle elective procedures often using K-wires for fixation. K-wire associated complications led to development of intramedullary fixation devices. We hypothesized that X Fuse (Stryker) and Smart Toe (Stryker) would provide stronger and stiffer fixation than K-wire fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>12 cadaveric second toe pairs were used. In one group, K-wires stabilized 6 PIP joints, and 6 contralateral PIP joints were fixed with X Fuse. A second group used K-wires to stabilize 6 PIP joints, and 6 contralateral PIP joints were fixed with Smart Toe. Specimens were loaded cyclically with extension bending using 2-N step increases (10 cycles per step). Load to failure and initial stiffness were assessed. Statistical analysis used paired t tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>K-wire average failure force, 91.0 N (SD 28.3), was significantly greater than X Fuse, 63.3 N (SD 12.9) ( P &lt; .01). K-wire average failure force, 102.3 N (SD 17.7), was also significantly greater than Smart Toe, 53.3 N (SD 18.7) ( P &lt; .01). K-wire initial stiffness 21.3 N\/mm (SD 5.7) was greater than Smart Toe 14.4 N\/mm (SD 9.3) ( P = .02). K-wire failure resulted from bending of K-wire or breaching cortical bone. X Fuse typically failed by implant pullout. Smart Toe failure resulted from breaching cortical bone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>K-wires may provide stiffer and stronger constructs in extension bending than the X Fuse or Smart Toe system. This cadaver study assessed stability of the fusion site at time zero after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Our findings provide new data supporting biomechanical stability of K-wires for lesser toe PIP arthrodesis, at least in this clinically relevant mode of cyclic loading.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100718805066","type":"journal-article","created":{"date-parts":[[2018,10,20]],"date-time":"2018-10-20T06:02:57Z","timestamp":1540015377000},"page":"231-236","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Proximal Interphalangeal Arthrodesis of Lesser Toes Utilizing K-Wires Versus Expanding Implants: Comparative Biomechanical Cadaveric Study"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1613-5677","authenticated-orcid":false,"given":"Shane D.","family":"Rothermel","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Hershey College of Medicine, Penn State Hershey Bone and Joint Institute, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umur","family":"Aydogan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Hershey College of Medicine, Penn State Hershey Bone and Joint Institute, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan P.","family":"Roush","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Hershey College of Medicine, Penn State Hershey Bone and Joint Institute, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Hershey College of Medicine, Penn State Hershey Bone and Joint Institute, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,10,20]]},"reference":[{"key":"bibr1-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2017.10.019"},{"key":"bibr2-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2012.06.013"},{"key":"bibr3-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713519780"},{"key":"bibr4-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713519601"},{"key":"bibr5-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1177\/107110070002100202"},{"key":"bibr6-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1016\/S1083-7515(02)00002-5"},{"key":"bibr7-1071100718805066","unstructured":"Jacobs A. Podiatry today. https:\/\/www.podiatrytoday.com\/blogged\/are-digital-implants-more-cost-effective-k-wires. Published 2013. Accessed July 6, 2018."},{"key":"bibr8-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2014.10.003"},{"key":"bibr9-1071100718805066","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.0105"},{"key":"bibr10-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1177\/1938640013480237"},{"key":"bibr11-1071100718805066","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0916"},{"key":"bibr12-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714568013"},{"key":"bibr13-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717745854"},{"key":"bibr14-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2006.05.004"},{"key":"bibr15-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2013.02.007"},{"key":"bibr16-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1177\/1938640016681069"},{"key":"bibr17-1071100718805066","doi-asserted-by":"publisher","DOI":"10.1177\/107110079501600809"}],"container-title":["Foot &amp; Ankle International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100718805066","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1071100718805066","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100718805066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:23:10Z","timestamp":1777411390000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1071100718805066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,20]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1177\/1071100718805066"],"URL":"https:\/\/doi.org\/10.1177\/1071100718805066","relation":{},"ISSN":["1071-1007","1944-7876"],"issn-type":[{"value":"1071-1007","type":"print"},{"value":"1944-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,20]]}}}