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Use of a Kirschner Wire for Distraction and Capsular Flaps in the Keller Interpositional Arthroplasty

Ricardo Becerro de Bengoa Vallejo, DPM, PhD ^*, Marta Elena Losa Iglesias, PhD , Fermin Viejo Tirado, PhD , Juan Carlos Prados Frutos, PhD  and Kevin T. Jules, DPM 

^* Universidad Complutense de Madrid, Madrid, Spain.
Universidad Rey Juan Carlos, Alcorón, Madrid, Spain.
Departamento de Ciencias Morfólogicas y Embriología, Universidad Complutense de Madrid, Madrid, Spain.
New York College of Podiatric Medicine, Brooklyn, NY.

Corresponding author: Ricardo Becerro de Bengoa Vallejo, DPM, PhD, Universidad Complutense de Madrid, Avenida Complutense s/n, Madrid, 28040 Spain. (E-mail: ribebeva{at}enf.ucm.es)

Abstract

We describe a simplified capsular interpositional technique for the Keller bunionectomy that uses a Kirschner wire to interpose the capsule into the first metatarsophalangeal joint without requiring sutures. The capsule acts as a biologic spacer in the first metatarsophalangeal joint, allowing for fibrosis to fill the void created, with the Kirschner wire maintaining the distance between the metatarsal head and the stump of the proximal phalanx. This creation of a nonpainful pseudarthrosis prevents shortening of the hallux and retraction of the base of the proximal phalanx on the metatarsal head. (J Am Podiatr Med Assoc 98(4): 326–329, 2008)