First Metatarsophalangeal Joint Arthrodesis

Outcomes of First Metatarsophalangeal Joint Fusion Using a Precontoured Plate

BACKGROUND

The purpose of this study was to determine the results of an arthrodesis technique of the first metatarsophalangeal joint (MTPJ) using a precontoured dorsal plate to correct the hallux valgus deformity.

METHODS

This was a retrospective analysis of outcomes for first MTPJ arthrodesis performed using 2 precontoured dorsal plates. Radiographic outcomes (intermetatarsal angle [IMA] and hallux valgus angle [HVA]) and patient-reported functional outcome measures (Short-Form 12 and Foot and Ankle Outcome Score) were recorded and compared.

RESULTS

Fifty-five patients underwent 77 first MTPJ arthrodeses for severe hallux valgus deformity with associated degenerative changes at the first MTPJ. The mean reduction of the IMA was 5.67° (P < .05) and the mean reduction of the HVA was 33° (P < .05). The Short-Form 12 assessment of global health demonstrated a significant improvement in both the physical and mental health composite scores by 16.4 points and 10.4 points (P < .05), respectively. The Foot and Ankle Outcome Score demonstrated a cumulative decrease of 35% (59.28; P < .05) in all domains.

CONCLUSIONS

First MTPJ arthrodesis using a precontoured dorsal plate is a successful procedure with a high union rate, low complication rate, and a high level of patient-reported satisfaction.

LEVELS OF EVIDENCE

Level III.

First metatarsophalangeal joint arthrodesis; what is the best fixation option? A critical review of the literature

First metatarsophalangeal joint arthrodesis can be accomplished using many forms of fixation. Distinguishing the best fixation construct requires evaluation of many variables. A review of the literature provides a starting point for what needs to be assessed and what questions need to be asked. In vivo and in vitro studies attempt to provide answers but frequently reveal shortcomings in the evidence to date. In the end, there is always 1 best fixation technique.

Hallux IP arthritis after MP arthrodesis managed with interpositional arthroplasty of MP joint and IP fusion: case report

Level of Evidence: V, Expert Opinion

First metatarsophalangeal arthrodesis for hallux rigidus

Hallux rigidus leads to a restricted and painful motion at the first metatarsophalangeal (MTP 1) joint. Decision making of the appropriate surgical procedure mainly refers to the stage of hallux rigidus. If conservative measures fail, operative procedures can be taken into consideration. Arthrodesis of the MTP 1 joint is widely accepted as the gold standard for end-stage hallux rigidus. Despite the fusion of a key joint, there is little adverse effect on gait, and weight bearing of the first ray can be restored.