The preferred procedure of choice for toes two, three, and four is the digital arthrodesis. It is easily understood why this procedure is performed so often. The results are predictable, significantly less shortening, and no abnormal rotations or deviations. The arthrodesis procedure has increased significantly over the years as seen by the increase in new product development. These include snap infusion devices, Silastic type implants, impact wires, and a significantly improved form of fixation, the BioPro Digital Compression Screw.

For years, the most common performed arthrodesis procedure has fixation by K-wire. True, this is extremely quick and easy to perform. However, the success rate of this type of fixation is extremely low. Exposed wires increase the chances of infection. Very often, the ends become loose and may retract after one or two dressing changes. The procedure has now failed. Surgeons desire a product with a high success rate with a decrease in complication factors. The BioPro Digital Compression Screw was developed incorporating the gold standard (screw fixation) for bone fusions.

As a resident and soon-to-be new practitioner, one must ask him or herself,” What is my surgical philosophy?” “Do I want to perform the easiest procedures in the least amount of time or perform the surgical procedure which affords the highest degree of success using the best type of equipment available?”

During my residency program and even now in private practice, the excitement is still there to try new products that became available. I never forgot one major theme that was imparted to me during my residency training and one which I teach to the residents who rotate through my hospital. Each surgeon will have different innate hand surgical skill abilities, but what makes a good surgeon a better surgeon is the ability to develop a “way out” if the surgery does not go exactly as planned.

Let's review. Using a snap fusion device, if a placement error has been made, there is no way out. If an implant is used and seats incorrectly, is there a substitute implant? If an impact wire does not seat well or approximate well, what’s next? However, in screw fixation, if the 1.5 mm BioPro Digital Compression Screw does not purchase or coaptate as desired, there is a way out! You now have the opportunity to increase screw size to a 1.8 mm BioPro Digital Compression Screw for greater purchase. It's rather simple; why not choose a product that affords that additional safety factor? Cost containment is always on the minds of hospitals and surgicenters. The Digital Compression Screw is the least expensive of all the products, second only to the K-wire.

A learning curve is expected with all new procedures. Once you have performed an arthrodesis using the BioPro Digital Compression Screw, the excitement is back!