A Consecutive Case Series of 166 First Metatarsophalangeal Joint Fusions Using a Combination of Cup and Cone Reamers and Crossed Cannulated Screws

Asif, Muhammad; Qasim, Sultan N.; Kannan, Sudhir; Bhatia, Maneesh

doi:10.1053/j.jfas.2017.10.026

Cited by 24 publications

(21 citation statements)

References 12 publications

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“…When two parallel screws (cost~200 Euro per 1 headless screw) were used in 60 ft a union rate of 100% was achieved and no hardware removal was reported [10]. Two crossed screws have led to a 93.3% union rate [12]. When only one intramedullary screw was used in 109 ft, union was achieved in 104 (95.4%) joints, but 85 (78%) of these patients have undergone a hardware removal due to a prominent hardware.…”

Section: Discussionmentioning

confidence: 99%

“…A few fixation devices were described in order to obtain additional stability in the fused joint: a lag screw, a dorsal plate, crossed screws, staples and an intraosseous device [6]. The union rate with various implants was found to be consistently around 91 to 100% [7][8][9][10][11][12][13][14] and the need for reoperation due to a prominent hardware was usually between 0 and 13% [6][7][8][9][10][11][12][13][14] (with the exception of 78% in one study [15]). These reports imply a relative success in obtaining union, but in some cases, as in a single screw implant or a dorsal plate, the secondary procedure rates seem to be too high.…”

Section: Introductionmentioning

confidence: 99%

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Does the IOFix implant improve union rates?

Segal

Ohana

Nyska

et al. 2020

BMC Musculoskelet Disord

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Background First metatarso-phalangeal joint fusion is the current gold standard for severe hallux rigidus. Data regarding the union rate and the re-operation rate when IOFix (an Intra-osseous fixation device, Extremity medical, New Jersey, USA) is used for hallux rigidus fusion is limited but promising. The aim of this study was to review our outcomes with the IOFix implant. Methods We have conducted a retrospective chart review, following the approval of the hospital IRB committee. Exclusion criteria included bilateral operations on the same patient, multiple surgeries, charcot foot or other structural foot abnormalities (except hallux valgus), rheumatoid arthritis and a recent foot trauma. We collected demographic data, physical examination documentation, functional score evaluations (AOFAS), and Plain radiographic studies. Results Thirty patients were included in the study. The mean age was 60.36 ± 9.12 (range 36 to 77) years, 18 (60%) female patients and 12 (40%) male. Fourteen (53.33%) were left side pathologies. The average follow up period was 36.2 ± 12.31 (range 12 to 54) months. Union was obtained in 28 (93.33%) patients, of whom none had requested a hardware removal due to a prominent hardware during a minimum of 2 year follow up period. The mean postoperative AOFAS score was 80.5 ± 10.87 (range 35 to 90). A more stringent inclusion criteria and fusion definitions would have led to an exclusion of two more patients and a dropout of two patients from the “fused” group, which would have led to a fusion rate of 85.71%. Conclusions This is the largest series of hallux rigidus patients that were operated with an IOFix device. The rates of fusion and hardware removal in MTPJ1 arthrodesis performed with an IOFix implant were found to be similar at most when compared to previously described rates that were obtained with other cheaper and more simple fixation devices. Level of evidence 4

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does the IOFix implant improve union rates?

Segal

Ohana

Nyska

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…[10] Two crossed screws have led to a 93.3% union rate. [12] When only one intramedullary screw was used in 109 feet, union was achieved in 104 (95.4%) joints, but 85 (78%) of these patients have undergone a hardware removal due to a prominent hardware. This removal rate was exceptional, and alarmingly high.…”

Section: Discussionmentioning

confidence: 99%

“…A few xation devices were described in order to obtain additional stability in the fused joint: a lag screw, a dorsal plate, crossed screws, staples and an intraosseous device. [6] The union rate with various implants was found to be consistently around 91% to 100% [7][8][9][10][11][12][13][14] and the need for reoperation due to a prominent hardware was usually between 0-13% [6][7][8][9][10][11][12][13][14] (with the exception of 78% in one study [15]). These reports imply a relative success in obtaining union, but in some cases, as in a single screw implant or a dorsal plate, the secondary procedure rates seem to be too high.…”

Section: Level Of Evidence: 4 Backgroundmentioning

confidence: 99%

Does the IOFix implant Improve Union Rates?

Segal

Ohana

Nyska

et al. 2020

Preprint

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BACKGROUND First metatarso-phalangeal joint fusion is the current gold standard for severe hallux rigidus. Data regarding the union rate and the re-operation rate when IOFix (an Intra-osseous fixation device, Extremity medical, New Jersey, USA) is used for hallux rigidus fusion is limited but promising. The aim of this study was to review our outcomes with the IOFix implant. METHODS We have conducted a retrospective chart review, following the approval of the hospital IRB committee. Exclusion criteria included bilateral operations on the same patient, multiple surgeries, charcot foot or other structural foot abnormalities (except hallux valgus), rheumatoid arthritis and a recent foot trauma. We collected demographic data, physical examination documentation, functional score evaluations (AOFAS), and Plain radiographic studies. RESULTS Thirty patients were included in the study. The mean age was 60.36±9.12 (range 36 to 77) years, 18 (60%) female patients and 12 (40%) male. Fourteen (53.33%) were left side pathologies. The average follow up period was 36.2±12.31 (range 12 to 54) months. Union was obtained in 28 (93.33%) patients, of whom none had requested a hardware removal due to a prominent hardware during a minimum of 2 year follow up period. The mean postoperative AOFAS score was 80.5±10.87 (range 35 to 90). A more stringent inclusion criteria and fusion definitions would have led to an exclusion of two more patients and a dropout of two patients from the “fused” group, which would have led to a fusion rate of 85.71%.CONCLUSIONS This is the largest series of hallux rigidus patients that were operated with an IOFix device. The rates of fusion and hardware removal in MTPJ1 arthrodesis performed with an IOFix implant were found to be similar at most when compared to previously described rates that were obtained with other cheaper and more simple fixation devices.LEVEL OF EVIDENCE: 4

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“…Asif y colaboradores obtuvieron una tasa de seudoartrosis de 6.6% con fijación con tornillos canulados cruzados en una serie de 166 pies; asimismo, Donegan y colegas en una serie de 262 pies fijados con tornillos canulados cruzados obtuvieron 96.18% de tasa de fusión, con un AOFAS medio de 52 y una satisfacción de 90.72%. 8,9 Estos resultados, comparables con los nuestros, objetivan resultados muy satisfactorios de los tornillos canulados aunque sin compararlos con otros métodos de fijación. Las placas bloqueadas son de uso más reciente y por ello no existen grandes series de pacientes y los estudios comparativos, a pesar de avalar buenos resultados, no encuentran diferencias significativas comparando con otros métodos de fijación.…”

Section: Discussionunclassified