In Vivo Comparison of Screw versus Plate and Screw Fixation for First Metatarsophalangeal Arthrodesis: Does Augmentation of Internal Compression Screw Fixation Using a Semi-Tubular Plate Shorten Time to Clinical and Radiologic Fusion of the First Metatarsophalangeal Joint (MTPJ)?

Sharma, Himanshu; Bhagat, Shaishav; DeLeeuw, John; Denolf, Frans

doi:10.1053/j.jfas.2007.10.006

Cited by 29 publications

(13 citation statements)

References 10 publications

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“…Many different techniques and osteosynthesis implants have been used, including cross screws fixation, fixation with locking or non-locking plate and screws with or without lag screws and staples. [1][2][3][4][5][6][7] This study reports the outcome of fusion of the first MTPJ using the Fyxis plate and compression screws.…”

Section: Introductionmentioning

confidence: 99%

First Metatarsophalangeal Joint Fusion Using a Fyxis Plate

Marudanayagam

Appan

2014

J Orthop Surg (Hong Kong)

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Section: Introductionmentioning

confidence: 99%

First Metatarsophalangeal Joint Fusion Using a Fyxis Plate

Marudanayagam

Appan

2014

J Orthop Surg (Hong Kong)

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“…This has not been reported previously in the literature. A previous study compared an interfragmentary screw only fixation with interfragmentary screw and dorsal plate fixation [ 12 ], and found no significant difference between the groups. Our work supports a biomechanical study by Politi et al (2003) that showed the combination of dorsal plate and compression screw was the strongest construction [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

First Metatarsalphalangeal Joint Arthrodesis: A Retrospective Comparison of Two Methods of Fixation

Rashid¹,

Parnell²,

Khan³

et al. 2015

TOORTHJ

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First metatarsalphalangeal joint arthrodesis is a well established and successful treatment; however there still remains controversy over the best choice of construct. We performed a retrospective study of patients undergoing first metatarsalphalangeal fusion over eighteen months (n=52) using either dorsal non-locking plate with additional compression lag screw fixation or dorsal non-locking plate alone. We found when assessing clinical criteria, patients with dorsal non-locking plates and additional compression lag screw fixation had a significantly higher rate of fusion (100% vs 77.8%), significantly higher rate of fusion within the first two months (55.6% vs 83.3%), significantly earlier time to fusion (52.2 days vs 75.6 days), and significantly lower rate of non-union (0% vs 22.2%). When blindly assessing radiographic criteria, the patients treated with the plate and compression screw had a significantly higher rate of fusion and lower rate of non-union (0% vs 33%). There was no statistically significant difference between the frequencies of complications in the groups. We believe that the interfragmentary compression is a crucial factor in achieving good union rates and recommend the use of non-locking pre-contoured plating with additional interfragmentary compression screw as the fixation method of choice for these procedures.

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“…7,25,33,37 Fixation for arthroscopic MTPJ fusion can be achieved by crossing compression lag screws. 10,20,24 Compression lag screws were previously compared with standard dorsal plates, 4,12,29,34 and standard plates were shown to be mechanically superior. Fully threaded headless screws may provide superior stability when compared with compression lag screws because the threads engage the cortex in 3 places, the outer cortex at the site of insertion and both cortices at the MTPJ.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Comparison of Low-Profile Contoured Locking Plate With Single Compression Screw to Fully Threaded Compression Screws for First MTP Fusion

et al. 2019

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Background: Open metatarsophalangeal (MTP) arthrodesis using locked plates produces good clinical outcomes. However, arthroscopic fusion with new-generation fully threaded compression screws is emerging as an alternative. The purpose of this study was to compare low-profile contoured locked plates with fully threaded compression screws for first MTP fusion, in a biomechanical cadaveric model. Methods: The first rays of 8 matched pairs of fresh frozen cadaveric feet underwent dissection and dual-energy x-ray absorptiometry (DEXA) scanning to measure bone mineral density (BMD). The “plate” group was prepared with cup-and-cone reamers, and fixation of the MTP joint with 1 compression screw and low-profile dorsal locked plate. The matched-pair “screws” group was prepared through a simulated arthroscopic technique, achieving fixation with 2 new-generation fully threaded compression screws. The plantar MTP gap was recorded with an extensometer during 250 000 90-N cyclic loads followed by a single load to failure. Results: The screw group demonstrated significantly greater stiffness, 31.6 N/mm (plates) and 51.7 N/mm (screws) ( P = .0045). There was no significant difference in plantar gapping or load to failure, 198.6 N (plates) and 290.1 N (screws) ( P = .2226). Stiffness and load to failure were highly correlated to BMD for the screw group, r =0.79 and r = 0.94, respectively, but less so for the plate group, r = 0.36 and r = 0.62, respectively. The maximum metatarsal head height measured on the lateral view was strongly correlated with load to failure for both the plate- and screw-only groups ( r > 0.9). Conclusion: These data demonstrate that hallux MTP arthrodesis utilizing fully threaded compression screws had similar plantar gapping and load to failure when compared with the low-profile locking plate, but with significantly more stiffness. These results support an increased role of fully threaded screws for MTP arthrodesis using either the arthroscopic or open technique. However, with decreased BMD plate fixation may remain the better fixation choice. Clinical Relevance: Our data suggest that with regard to construct stability, fully threaded headless compression screws may be just as effective as low-profile locking plates, but BMD and MTP joint fluoroscopic measurements should be considered in the decision-making process for fixation.

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In Vivo Comparison of Screw versus Plate and Screw Fixation for First Metatarsophalangeal Arthrodesis: Does Augmentation of Internal Compression Screw Fixation Using a Semi-Tubular Plate Shorten Time to Clinical and Radiologic Fusion of the First Metatarsophalangeal Joint (MTPJ)?

Cited by 29 publications

References 10 publications

First Metatarsophalangeal Joint Fusion Using a Fyxis Plate

First Metatarsophalangeal Joint Fusion Using a Fyxis Plate

First Metatarsalphalangeal Joint Arthrodesis: A Retrospective Comparison of Two Methods of Fixation

Biomechanical Comparison of Low-Profile Contoured Locking Plate With Single Compression Screw to Fully Threaded Compression Screws for First MTP Fusion

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