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PIP Fusion

The Proximal Interphalangeal Joint, or PIP Joint, is the second joint of your lesser toes. Hammertoe and claw toe conditions can cause this joint to become fixed and unable to straighten. This is a gradual deformity and cannot be straightened by any means other than surgery.

The surgery required to straighten your toes typically involves removal of bone portions through an incision on top of your toe. The bone removal allows your toe to be straightened. Once straightened, a long wire known as a K-wire is pushed through the front of your toe, with a portion sticking out of the end of your toe. This wire helps keep your toe in a fixed position for four to six weeks, and is then removed.

These types of surgery have multiple issues with pain and fusion, and 10 to 46 percent of patients are dissatisfied post-surgery.1

The complications of a K-wire type of surgery are many and include2:

  • Increased swelling and pain
  • Pin-tract (site of wire insertion) infection
  • Delayed or incomplete joint fusion
  • Painful removal of wire

Less Invasive

The HAT-TRICK PIP Fusion system provides an alternative to wires sticking out of your toes. The HAT-TRICK PIP Fusion system consists of a device known as a PEEK (polyetheretherketone) implant, which is a technology that has been used in orthopaedic and spine procedures for many years. The PEEK implant is radiolucent, which allows your surgeon – and you – to see the fusion progress on an x-ray. By contrast, metal implants such as wires and screws appear solid on an x-ray and do not always allow a full view of your healing. The HAT-TRICK PIP Fusion system also provides your surgeon with a technology designed to achieve a better fusion and, ultimately, a less invasive healing process.

The surgery involves an incision to gain access to the joint and minimal bone removal. Your surgeon will implant the HAT-TRICK PIP device into your toe with half in the middle phalanx and half in the proximal phalanx. This unique compression technology is exclusive to the HAT-TRICK PIP Fusion System and holds your toe in place, allowing full fusion to occur.

Anatomically Correct

The HAT-TRICK PIP device is available as a straight, or 10-degree curve implant, to return your toes to their anatomically correct position. Based on your condition, your surgeon will ultimately determine if a 0° or a 10° is most appropriate for you.

For more information about the HAT-TRICK PIP Joint Repair System, please contact your surgeon.


1. Barg A, Courville XF, Nickisch F, Bachus KN, Saltzman C. Role of Collateral Ligaments in Metatarsophalangeal Stability: A Cadaver Study. Foot Ankle Int 2012; 33:877-882.

2. Angirasa AK, Barrett MJ, Silvester D. Smart Toe® Implant Compared with Kirschner Wire Fixation for Hammer Digit Corrective Surgery: A Review of 28 Patients. J Foot Ankle Surg 2012; 51:711-713.

The information listed on this site is for informational and educational purposes and is not meant as medical advice. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation.The information on this site does not replace your doctor's specific instructions.