Suffering from hammertoes since she was a child, Jenecia Reames, 27, is finally beginning to enjoy a life free of the debilitating and painful condition, thanks to an inventive Atlanta podiatrist and an innovative Memphis-based medical device company.

Traditional K-Wire Fixation versus ARROW-LOK™ Digital Fusion System

Hammertoes is the common name for proximal interphalangeal joint flexion deformity, a progressive and often painful condition in which the toes are held in a flexed or bent position. Traditionally, the only surgical treatment has relied on Kirschner external wires or “K-wires” that are left protruding from the front of the toe for several weeks after surgery. Additionally, the wires have to be removed before the bones are fully healed, which can compromise stability or even cause the fusion to fail. Seeking “a better approach,” Scott Roman, DPM, of The Ankle and Foot Centers of Georgia, invented a new surgical implant for hammertoe correction about two years ago. The ARROW-LOK™ Digital Fusion System is now being marketed nationally by Memphis-based Arrowhead Medical Device Technologies, LLC.
When she saw Roman for the first time about three years ago, Reames considered having the K-wire surgery. “I was pregnant at the time so was unable to undergo surgery,” she explains. “But I also had an aunt who had had the surgery with wires on both feet, and she didn’t recommend it.”
Unfortunately, Reames’ condition worsened after her pregnancy. “I could get around, but the pain was constant all day. I had to have a footstool to keep my feet propped up, and any pressure at all would cause pain.” Going back to Roman in early 2012, Reames could easily see the difference in her X-rays. “The hammertoes were getting worse,” she says.
Fortunately, the ARROW-LOK system had become available by then, and the podiatrist recommended it to the young wife and mother. “Dr. Roman told me about the new implant and told me that it would be more convenient for me. I’d be back on my feet sooner.”
Reames opted to have her surgery on one foot at a time, and Roman operated on her left foot in June 2012, using the ARROW-LOK system to correct toes two through five (all but the big toe). Following the outpatient procedure, Reames returned home the same day and spent five days off her feet as much as possible. During her recovery, Reames utilized a medical ice machine for five weeks to reduce swelling, and continued to wear a boot to protect and support her foot for several more weeks. Roman also taught her how to exercise her foot to ensure flexibility as it healed.
“I was able to go back to work pretty quickly,” Reames says. “My swelling was about half what it was supposed to be, and now I’m wearing a shoe again. I have to guard against bumping the foot, of course, but for the most part I walk around like I never had a problem. And that’s why I had the second foot done.”
Following her excellent experience with her left foot, Reames had Dr. Roman perform the same procedure on the same toes of her right foot in early September.
Roman says he has used the ARROW-LOK system on patients of all ages, including many who had previously refused to have the surgery using K-wires. “Many patients worry about stubbing the toe with the wire sticking out or even accidentally pulling it out. The ARROW-LOK system is a comparatively anxiety-free postoperative experience for them.”
Reames’ experience has certainly inspired other family members to reconsider the surgery. “My father and sister are both looking at having the same the procedure. My father’s toes are as bad as mine were, and he’s been putting it off for years.”
Asked what she would recommend to others suffering from hammertoes, Reames quickly answers, “The first thing is I’d probably send them to Dr. Roman. The implants compared to the wires are great — and the ice machine really helped me during the recovery.”
Now healing from surgery on her right foot, Reames is looking forward to a more normal life. Whether she’s chasing after her lively two-year-old daughter, practicing yoga or simply walking to the office on her job as a hospital billing coordinator, she’ll be able to wear shoes, stand and walk without severe pain for the first time in years.
“That’s really the point of creating this new system,” Roman continues. “I want to help my patients regain what they’ve lost. If you can wear shoes comfortably and do the things you want to do, it’s a great improvement in the quality of life.”

Traditional K-Wire Fixation versus ARROW-LOK™ Digital Fusion System
Traditional fixation places Kirschner external wires (K-wires) through both joints of the toe, including the last joint, which may be healthy and not involved in the hammertoe deformity (Figure A). The K-wire is left protruding from the end of the toe, creating a site of potential infection (Figure B). It is extracted four to six weeks later after the bones may have achieved an acceptable degree of healing (Figure C). The ARROW-LOK device is implanted completely inside the affected bones, providing permanent and stable fixation without involving healthy joints (Figure D). Use of the ARROW-LOK system also eliminates a potential site for infection, since nothing is left sticking out of the toe, and ensures a more comfortable recovery for the patient (Figure E).
Figure A: Radiograph of traditional fixation with external K-wire
Figure B: K-wire protruding from the end of the toe after surgery
Figure C: Extraction of the K-wire using forceps 4-6 weeks postop
Figure D: Radiograph of permanent ARROW-LOK implant
Figure E: Bandaged incision after implantation of the ARROW-LOK device
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Founded in August 2010, by Patrick Mullaney, President, and Tom Twardzik, Vice President, Sales and Marketing, Arrowhead Medical Device Technologies, LLC, specializes in rapidly developing, manufacturing and distributing medical devices utilized in the treatment of musculoskeletal conditions. The headquarters is located just outside of Memphis, Tennessee, a region recognized as one of the world’s premier sites for musculoskeletal medical device innovation. Arrowhead received clearance to market its initial product, the ARROW-LOK™ Digital Fusion System in October 2010, performed the first surgeries in December 2010 and commenced unrestricted distribution in February 2011. Arrowhead plans to expand its product lines to include additional sizes and applications for the ARROW-LOK technology. In addition, the management of Arrowhead is actively seeking innovative medical device technologies that serve to improve patient care in an effective and affordable manner. (www.arrowheaddevices.com)
The Ankle and Foot Centers of Georgia is a long-established group of Board Certified podiatric physicians who are highly skilled innovators in the field of foot and ankle medicine. Founded in 1982 on the principles of technical excellence and personal concern for their patients’ health and well-being, the Centers’ doctors strive to provide patients with the latest available treatment options from conservative care to surgical intervention. (www.ankleandfootcenters.com)