Complications of First Metatarsophalangeal Joint Arthrodesis

Hofbauer, Mark H.; Thun, Joshua D.

doi:10.1007/978-3-319-53686-6_13

Cited by 1 publication

(1 citation statement)

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“…Since the 1980s, fixation techniques have developed from suture, metallic wire, external fixation, Rush rods, and Steinmann pins to modern-day screws, plating systems, and staples [15]. As a result, modern fixation techniques have been postulated to promote fusion and functional outcomes whilst reducing fixation-related complications [16]. Roukis [15] performed a systematic review of 2818 FMPJ arthrodesis procedures finding an overall union rate of 94.6% and complication incidence of 6.1% for malunion and 8.5% for metalwork removal.…”

Section: Introductionmentioning

confidence: 99%

First metatarsophalangeal joint arthrodesis/fusion: a systematic review of modern fixation techniques

Kang

Bridgen

2022

Journal of Foot and Ankle Research

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Background First metatarsophalangeal joint arthrodesis is commonly performed for symptomatic end-stage hallux rigidus. It has been postulated to produce good results in the literature. Various fixation techniques offer differences in union rates, complications and functional outcomes, stirring debates about which produces the best outcomes for patients. Therefore, this review aims to synthesise and compare the outcomes of modern fixation techniques used for first metatarsophalangeal joint (FMPJ) arthrodesis. Methods The electronic database searched were PubMed, CINAHL, Cochrane Library, and Google Scholar. The critical appraisal skills programme tool for cohort study was used. The interventions consisted of screw(s), plate(s), and staple(s). Studies comprising outdated fixation techniques such as suture, metallic wire, external fixation, Rush rods or Steinmann pins were excluded. Participants were adults over 18 years, undergoing FMPJ arthrodesis in the UK. Studies with the population consisting primarily of revision cases, patients with rheumatoid arthritis or diabetes were excluded. Results Seven UK studies included 277 feet and a 95.7% overall union rate at a mean union time of 83.5 days. Staples had the highest union rate of 98.2% at mean union time of 84 days, followed by plates (95.2%, 92 days), and finally screws (94.9%, 71 days). The overall complication incidence is 5.8%. All of the fixation techniques produced good functional outcomes postoperatively. Conclusions Whilst staple techniques showed the highest union rate, plating techniques are preferable over screws or staples for better results across several outcome measures, including reduced complication incidence, stability, early ambulation, and good functional outcome. The Manchester-Oxford Foot Questionnaire and EuroQol-5Dimensional are recommended as measurement tools to assess functional outcomes following FMPJ arthrodesis.

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Section: Introductionmentioning

confidence: 99%