Comparison of Hallux Interphalangeal Joint Arthrodesis Fixation Techniques: A Retrospective Multicenter Study

Thorud, Jakob C.; Jolley, Tyler; Shibuya, Naohiro; Lew, Eric; Britt, Matthew; Butterfield, Ted; Boike, Alan; Hardy, Mark A.; Brancheau, Steven P.; Motley, Travis A.; Jupiter, Daniel C.

doi:10.1053/j.jfas.2015.04.007

Cited by 7 publications

(11 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The nonunion rates are higher than the 10% nonunion rate reported by Shives and Johnson 5 in their cohort of 20 patients receiving retrograde screw fixation for their HIPJA. However, when compared to a study of similar magnitude like Thorud et al’s 8 multicenter study with nonunion rates of 23.1%, 23%, and 28% for, respectively, crossed screw, single screw, and “other” configurations we find that they are similar to ours.…”

Section: Discussionsupporting

confidence: 87%

“…A total of 48 patients required reoperations (“additional procedures”) in our series (21.1%), which again was similar to the rate of reoperation published in a series of 152 patients published by Thorud et al in 2016 (23%). 8 Patients with radiographic nonunion were at higher risk for all-cause reoperation (39.7%) than patients with radiographic union (14.8%) in our series (Table 2, P < .0001, odds ratio 3.785). Many patients required reoperation despite successful arthrodesis for a mix of symptomatic hardware and wound healing or infection related complications.…”

Section: Discussionmentioning

confidence: 55%

“…Union was defined as 2 cortical continuations or bridging at the arthrodesis site itself, absence of hardware failure, and the absence of lytic gapping of the arthrodesis and/or a computed tomography (CT) scan revealing bridging bone across the fusion site. 8 At these routine follow-up visits, patients underwent clinical testing of the toe that includes strength, stability, wound healing, and range of motion. Routine radiographs are also obtained at the 6-week and 3-month intervals and include standing 3-view radiographs of the operative foot.…”

Section: Methodsmentioning

confidence: 99%

“…6 Multiple methods of fixation have been described in order to obtain fusion of the HIPJ, including but not limited to Kirschner (K)-wires, screws, staples, plates, and several combinations of these methods. 1-8 Shives and Johnson 5 originally described a method of fixation using K-wires but altered their technique to screw fixation because of a high rate of nonunion. Despite the advances in orthopaedic fixation methods, the technique for HIPJA has largely remained unchanged.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes After Hallux Interphalangeal Joint Arthrodesis

Braswell,

Hysong,

Macknet

et al. 2023

Foot Ankle Int.

View full text Add to dashboard Cite

Background Hallux interphalangeal joint arthrodesis (HIPJA) is indicated for a variety of pathologies. Despite high nonunion rates, techniques remain unchanged. The aim of this study is to examine nonunion and complication rates and describe risk factors for treatment failure. Methods A query of an institutional database was performed to identify all patients undergoing HIPJA procedure over a 10-year period. Records were reviewed to the procedure, evaluate patient factors, indications, and radiographic/clinical arthrodesis. Radiographic union was defined as 2 cortical continuations or bridging at the arthrodesis site, absence of hardware failure, and the absence of lytic gapping of the arthrodesis. Clinical fibrous union was defined as radiographic nonunion with painless toe range of motion and physical examination consistent with fusion across the interphalangeal joint. Results Two hundred twenty-seven primary HIPJA procedures were identified. Our cohort demonstrated a 25.5% nonunion rate (58/227) and 21.1% reoperation rate (48/227). Patients with diabetes were at higher risk for nonunion ( P = .014), but no significant differences were identified based on smoking status or diagnosis of inflammatory arthritis. No difference was seen between implant groups: single screw, multiple screws, screw plus other fixation, nonscrew fixation. Patients with prior hallux metatarsophalangeal joint arthrodesis did not have a significantly higher nonunion rate than patients without prior first metatarsophalangeal joint arthrodesis. Patients diagnosed with radiographic nonunion were at higher risk for reoperation ( P < .0001). Conclusion Our cohort represents the largest single-center series of HIPJA procedures published to date. We found relatively high nonunion and reoperation rates with standard current techniques. Level of Evidence: Level III, retrospective case series.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 55%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes After Hallux Interphalangeal Joint Arthrodesis

Braswell,

Hysong,

Macknet

et al. 2023

Foot Ankle Int.

View full text Add to dashboard Cite

show abstract

“…Indeed, reported infection and dehiscence rates have ranged from 0% to 15%; and nonunion rates have been reported to range from 0% to 44%. 10,11 A recent retrospective multicenter study by Thorud et al 12 showed clinical and radiographic nonunion rate of greater than or equal to 17.8% and greater than or equal to 13.8% for HIPJ fusion respectively, contributing to a 27% reoperation rate. Such reoperation rate is well within the reported high range of 16% to 40% from previous studies.…”

Section: Discussionmentioning

confidence: 99%