Abstract
BackgroundFirst metatarsophalangeal joint (MTPJ) fusion is the most effective technique for the treatment of MTPJ primary arthritis, severe hallux valgus and failure of primary corrective surgery of these conditions. It can be achieved through different techniques. We evaluated the outcomes in a cohort of patients treated with dorsal plate arthrodesis.Materials and methodsWe treated 30 feet for 28 patients; the mean follow-up was 35 months. For each foot, we collected radiological and clinical assessment, with the visual analogue scale (VAS) for pain and the Manchester and Oxford Foot questionnaire (MOFQ). The technique consisted in a cup and cone arthrodesis with the application of a low profile dorsal plate. Patients were allowed for immediate weight bearing.ResultsConsolidation was achieved in all cases; in 29 cases, radiographic union was recorded within 6 months from surgery, in one case after 9 months. Comparison between the preoperative and postoperative of VAS and MOXFQ values showed a statistically significant difference (p < 0.05). Only one case developed wound dehiscence as complication.ConclusionsEven if there is still a debate regarding the best system for MTPJ fusion, we believe cup and cone fusion with dorsal plating is an effective method. Moreover, the stability of the osteosynthesis obtained allows for immediate post-operative weight bearing, making patients able to return soon to their normal life.Trial registrationWe present a retrospective study; all patients enrolled were retrospectively registered.
Highlights
First metatarsophalangeal joint (MTPJ) fusion is the most effective technique for the treatment of MTPJ primary arthritis, severe hallux valgus and failure of primary corrective surgery of these conditions
Even if there is still a debate regarding the best system for MTPJ fusion, we believe cup and cone fusion with dorsal plating is an effective method
The first metatarsophalangeal joint (MTPJ) fusion is a surgical procedure firstly described by Clutton in the last decade of 19th century [1]; despite of the several modifications introduced in the following years, it is still considered an effective technique for the treatment of several disorders of the first ray
Summary
First metatarsophalangeal joint (MTPJ) fusion is the most effective technique for the treatment of MTPJ primary arthritis, severe hallux valgus and failure of primary corrective surgery of these conditions. It can be achieved through different techniques. First MTPJ fusion aims to obtain a stable toe in order to reduce pain and discomfort This can be obtained through different techniques ranging from the use of Kirchner wires to the application of staples, screws and plates [4]. We report the clinical and radiological outcomes of a cohort of patients treated with dorsal plate arthrodesis without lag compression, allowed for immediate postoperative weight bearing
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