Background: Historically, Kirschner wires have been used for fixation of the interphalangeal joints of the toe. They are still the most popular form of fixation, likely due to training patterns, ease of use, and decreased cost. Recently, numerous medullary fixation devices have become available, including medullary screws.
Methods: After performing various forms of fixation for the correction of toe deformities, the authors have developed a new pilot hole technique for screw fixation advancing on the previously described pilot hole technique for Kirschner wire fixation.
Results: The authors have found this method to provide intraoperative confidence that improper hardware placement has not occurred.
Conclusions: The pilot hole technique described in this paper is a safe and effective technique that may be employed by surgeons using screw fixation for the treatment of hammertoe deformities. The technique reduces the possibility of surgeon error and helps to ensure that the screw is properly placed within the phalanges when properly employed.