Incidence of Nonunion of the Hallux Interphalangeal Joint Arthrodesis: A Systematic Review

So, Eric; Wilson, Matthew D.; Chu, Anson K.; Prissel, Mark A.

doi:10.1053/j.jfas.2018.01.002

Cited by 4 publications

(11 citation statements)

References 13 publications

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“…6 Overall nonunion rate in this study is similar to the rate of nonunion described in a recent systematic review. 6 These data confirm the high rate of nonunion with this procedure despite the transition from the historical K-wire technique to screw fixation in the vast majority of cases (205 with retrograde screw ± additional fixation in this series).…”

Section: Discussionsupporting

confidence: 89%

“…6,8 This study represents the largest single series of HIPJA, 6 and the largest number of hallux IPJ arthrodesis procedures performed with a single-screw technique (n = 180). 6 Overall nonunion rate in this study is similar to the rate of nonunion described in a recent systematic review. 6 These data confirm the high rate of nonunion with this procedure despite the transition from the historical K-wire technique to screw fixation in the vast majority of cases (205 with retrograde screw ± additional fixation in this series).…”

Section: Discussionmentioning

confidence: 99%

“…6,8 This study represents the largest single series of HIPJA, 6 and the largest number of hallux IPJ arthrodesis procedures performed with a single-screw technique (n = 180). 6…”

Section: Discussionmentioning

confidence: 99%

“…1,2,4,7 These include neuromuscular disorders, trauma, arthritis, rheumatologic sequela, claw toe, and pes cavus. 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.…”

Section: Introductionmentioning

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%

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Outcomes After Hallux Interphalangeal Joint Arthrodesis

Braswell,

Hysong,

Macknet

et al. 2023

Foot Ankle Int.

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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.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

“…6,8 This study represents the largest single series of HIPJA, 6 and the largest number of hallux IPJ arthrodesis procedures performed with a single-screw technique (n = 180). 6…”

Section: Discussionmentioning

confidence: 99%