First Metatarsophalangeal Joint Arthrodesis Using Memory Staples: Clinical and Functional Results

Abstract

Background. We present clinical and functional results of first metatarsophalangeal joint (MTPJ) arthrodesis using Memory staples. Methods. This retrospective observational study reviewed MTPJ arthrodesis with Memory staples from 2012 to 2016. Results. The mean age of 50 patients (55 feet) was 63 years (range 41-77 years). Forty-one feet were in women. Indication was hallux rigidus (n = 49) and hallux valgus (n = 6). The overall union rate was 98.2% (n = 54 of 55), including delayed healing in 3 (5.5%). The average time to union was 12 weeks. At a mean follow-up of 38 months (range 12-73 months), the mean Foot and Ankle Ability Measure score (47 out of 55, 86% response rate) was 87% (interquartile range 78%-100%). Complications included partial laceration of extensor hallucis longus (n = 1), wound infection (n = 4), wound-related (n = 2), lesser metatarsalgia (n = 3), cock up deformity (n = 1), and pain (n = 3). Conclusions. The high union rate, good patient satisfaction scores, and low rate of complications support our use of Memory staples. Levels of Evidence: Therapeutic, Level IV

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

“…As for functional outcomes, it was to synthesise the results due to vagueness in reporting, missing information, and variations in the measurement tools used. Challagundla et al [36], the only study using the staple technique, obtained the highest union rate of 98.2%, with a mean union time of 84 days. However, it has the highest complication incidence of 9.1%.…”

“…Even though a high union rate was achieved, this review's data revealed staples as inferior to other techniques in terms of stability and ability to allow early weightbearing. It should, however, be viewed with scepticism because it is just one study with a small sample size [36]. Further studies are needed to determine the stability and effectiveness of staples for FMPJ arthrodesis.…”

“…However, Neufeld et al [41] reported that staples provided the least stability compared to screw and plating techniques because the limbs are smooth polished metal with rounded edges, making them prone to slipping out of bone. The cohort with the three delayed unions [36] was allowed to mobilise fully weightbearing postoperatively, increasing the risk of micro‐movements within the joint and leading to a delayed union. It is also noteworthy that staples were used because it was the only available fixation device in the hospital; therefore, it is arguable that the delayed unions could have been avoided if plating techniques were used since they have been shown to provide superior stability, reducing the risk of micro‐movements [42].…”

“…Five studies [30,31,[34][35][36] had major concerns relating to lack of clarity when reporting definitions, patient recruitment, missing data, and no blinding of assessors. Two studies [32,33] had minor concerns because confounding factors were not accounted for by performing any stratification, multivariate models or regression analyses.…”

A Novel Plating System for First Metatarsophalangeal Joint Arthrodesis: A Retrospective Comparison of Hybrid and Traditional Locking Plate Constructs

“…These results were unsurprising, as a prior study showed staples provided sufficient compressive force to achieve fusion of the first MTPJ without the additional stability provided by the dorsal plating construct. 45,46 Outside of fusion rates, the operative time as well as the tourniquet time were less when the SCP alone (7 of 23) was used, in comparison with the LPP cohort where an interfragmentary screw was almost always used (17 of 21). However, this was not statistically significant.…”