Effect of Pathology on Union of First Metatarsophalangeal Joint Arthrodesis

Korim, M.T.; Allen, Patricia

doi:10.1177/1071100714549046

Cited by 35 publications

(24 citation statements)

References 14 publications

(22 reference statements)

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“…The rate of painful non-union was 1.5% for hallux rigidus and 0% for hallux valgus. This is slightly lower than recent published literature of 7% for hallux valgus and 3.7% for hallux rigidus [ 5 ], however fusion success rates have been reported in the literature at 80% - 100% [ 4 ]. Our results were comparable to a recent study by Kumar, et al, who used a similar operative technique for 46 patients with hallux valgus or hallux rigidus, and achieved a union rate of 98% [ 4 ].…”

Section: Discussioncontrasting

confidence: 59%

“…Our paper excluded patients with inflammatory arthropathies and those undergoing revision and salvage surgery. Korim and Allen performed a similar case series to ours in 2010 using flat cuts and cross screw fixation [ 5 ]. Their non-union rates were 6% in the hallux valgus group, and 0% in the hallux rigidus group.…”

Section: Discussionmentioning

confidence: 99%

“…All techniques give satisfactory results in the treatment for severe hallux valgus as well as hallux rigidus [ 1 - 4 ]. A review of the literature showed that nonunion following MTP joint arthrodesis for severe hallux valgus averaged 7%, almost double for hallux rigidus averaging 3.7% [ 5 ]. In addition, a recent single surgeon study had concluded that hallux valgus was associated with higher non-union rates [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…A review of the literature showed that nonunion following MTP joint arthrodesis for severe hallux valgus averaged 7%, almost double for hallux rigidus averaging 3.7% [ 5 ]. In addition, a recent single surgeon study had concluded that hallux valgus was associated with higher non-union rates [ 5 ]. However, biplanar cuts were used in all cases and either crossed screw fixation in the majority or a dorsal plate with or without a compression screw.…”

Section: Introductionmentioning

confidence: 99%

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First Metatarsophalangeal Joint Arthrodesis in Hallux Valgus Versus Hallux Rigidus Using Cup and Cone Preparation Compression Screw and Dorsal Plate Fixation

Chien

Alfred

Freihaut

et al. 2017

Cureus

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Various techniques have been described for first metatarsophalangeal (MTP) joint arthrodesis. The purpose of this study was to determine if cup and cone preparation by a single surgeon with an interfragmentary screw and dorsal plate fixation provides a comparable union rate in hallux valgus versus hallux rigidus. Our study included all patients who underwent first MTP joint fusions using cup and cone preparation with an interfragmentary compression screw and dorsal plate fixation from 2010 to 2015. We compared union rates in 65 patients with hallux rigidus with 47 who had hallux valgus. One of 65 hallux rigidus cases developed non-union and underwent revision surgery. One of 47 patients in the hallux valgus group developed a painless non-union. All other patients achieved union based on post operative radiographs. Our rate of painful non-union was 1.5% for hallux rigidus and 0% for hallux valgus, which is lower than recent published literature of 7% for hallux valgus and 3.7% for hallux rigidus. We found no difference between the two groups suggesting this method may provide stronger fixation and may be preferable when dealing with hallux valgus. First metatarsophalangeal joint fusion in patients with severe hallux valgus and hallux rigidus, using spherical reamers, compression screw and dorsal plate fixation is equally successful at achieving clinical and radiographic fusion in both hallux valgus and hallux rigidus.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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First Metatarsophalangeal Joint Arthrodesis in Hallux Valgus Versus Hallux Rigidus Using Cup and Cone Preparation Compression Screw and Dorsal Plate Fixation

Chien

Alfred

Freihaut

et al. 2017

Cureus

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“…The reported union rates with various techniques vary from 88% to 100%. 12 , 13 , 14 We conducted a retrospective study of 32 consecutive feet undergoing first metatarsophalangeal fusion with two locking plates placed at right angles without a compression screw. The aim of our study was to report the clinical and radiological outcomes with this technique.…”

Section: Introductionmentioning

confidence: 99%

First metatarsophalangeal joint arthrodesis with two orthogonal two hole plates

Fazal

Wong

Rahman

2018

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveFirst MTP joint fusion is a reliable procedure for advanced arthritis for the first MTP joint. There are many techniques described. The purpose of our study is to report clinical, radiological, functional outcomes and complications of first metatarsophalangeal joint fusion with hand preparation of the joint and fixation with two orthogonal locking plates without a compression screw.Methods32 feet in 26 consecutive patients under went first metatarsophalangeal joint fusion with above technique. There were 23 women and 3 men. Mean age was 64 years and mean follow-up was 49 months. 21 patients had osteoarthritis, 10 had rheumatoid arthritis and one had psoriatic arthritis. Clinical, radiological, American Orthopaedic Foot and Ankle Score and Foot and Ankle Disability Index clinical rating scales were used for evaluation.ResultsFusion was achieved in 27 feet. The incidence of radiological non-union was 15.7%. Mean AOFAS score improved from 37.1 to 80.7 (p < 0.0001) and mean FADI score improved from 40.3 to 86.9 postoperatively (p < 0.0001). Two patients with osteoarthritis and three with Rheumatoid arthritis did not unite. Four of these patients were managing hence revision surgery was not carried out but had low AOFAS and FADI scores. One patient with symptomatic non-union declined further surgery. One patient needed plate removal for a low grade infection and reoperation rate was 3.1%.ConclusionsIn our experience, first metatarsophalangeal joint arthrodesis using two orthogonal two hole plates without a compression screw is associated with a higher non-union rate in our cohort hence we do not recommend this technique.Level of evidenceLevel IV, therapeutic study.

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