Compression-Screw Arthroldesis of the First Metatarsophalangeal Joint of the Foot

1987 ◽  
Vol &NA; (221) ◽  
pp. 292???296
Author(s):  
IBRAHIM TURAN ◽  
URBAN LINDGREN
Keyword(s):  
Metatarsophalangeal Joint ◽  
Compression Screw ◽  
First Metatarsophalangeal Joint

Safety and Efficacy of Medial Plate in First Metatarsophalangeal Joint Arthrodesis

2021 ◽  
Vol 23 (3) ◽  
pp. 205-212
Author(s):  
Leszek Kuik ◽  
Piotr Łuczkiewicz
Keyword(s):  
Soft Tissues ◽  
Metatarsophalangeal Joint ◽  
Clinical Results ◽  
Dorsal Plate ◽  
Pain Level ◽  
Compression Screw ◽  
First Metatarsophalangeal Joint ◽  
Safety And Efficacy ◽  
The Mean ◽  
One Year

Background. Arthrodesis of the first metatarsophalangeal joint (MTP-1) is a recognized and effective procedure in advanced osteoarthritis of this joint. Fixation with a dorsal plate and a compression screw has been described as the most stable. Nevertheless, the frequency of revision procedures after MTP-1 arthrodesis has been reported to exceed 10% in some reports. The need for revision surgery is mostly related to the fixation material used and concern both its destabilization and a conflict between the implants and soft tissues. Therefore, there is still scope for developing new stabilization methods for the MTP-1 joint. Materials and methods. With the approval of the relevant Bioethics Committee, we conducted a pilot clinical trial to assess the safety and efficacy of the use of the medial plate in MTP-1 fusion. Twenty patients qualified for treatment due to osteoarthritis of the metatarsophalangeal joint were evaluated. The clinical results of the surgical treatment were assessed at least one year after the surgery. Results. The mean AOFAS MTP-IP score increased from 35.29±18.76 to 75.59±12.15. The mean EFAS score in­creased from 9.24±5.73 to 18.35±5.66. Pain level as per a VAS decreased from 6.24±1.48 to 1.59±2.58. A total of 18 patients were satisfied with the procedure, with the remaining 2 patients reporting the result as unsatisfactory. Two revision procedures were performed, both due to migration of the fixation material. Conclusions. 1. The clinical results of MTP-1 arthrodesis with the medial plate are comparable to the results in the litera­ture. 2. It can be concluded that the use of the medial plate in arthrodesis of the MTP-1 joint is safe and effective, and is a va­­luable alternative to existing methods.

Correlation analysis of the x-ray and functional parameters from the results of chevron (Austin) osteotomy for hallux valgus

2020 ◽  
pp. 54-63
Author(s):  
Ruslan Khairutdinov ◽  
Timur Minasov ◽  
Ekaterina Yakupova ◽  
Elvina Mukhametzyanova
Keyword(s):  
Hallux Valgus ◽  
Rating Scale ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
First Metatarsophalangeal Joint ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle ◽  
The Right ◽  
Bone Structures

Hallux valgus is characterized by the appearance and growth of a painful “lump” in the region of the first metatarsophalangeal joint, the development of forefoot corns, and inability to choose the right shoes, which leads to a significant decrease in the quality of life of these patients. Corrective osteotomies that preserve the metatarsophalangeal joint, for example Austin (Chevron) osteotomy, are usually used for hallux valgus deformity of the I, II degrees. Radiography with the study of the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMAA) is a research method that shows the true correlation between bone structures. The correlation between the radiological and functional indicators of osteotomy allows us to determine possible recommendations for indications for surgical treatment of Hallux valgus. Correlation shows that the largest correction of hallux valgus in older patients occurs due to a small adjustment of the angle of DMMA and HVA. IMA had the best correction after Austin osteotomy among patients of a younger age, then the HVA, and the DMMA had minimum correction according to the AOFAS rating scale (Kitaoka). The revealed correlations allow us to determine the correct tactics for the treatment of hallux valgus by identifying the benefits of Austin osteotomy.

scholarly journals Treatment of End-Stage Hallux Rigidus and Impact of Arthrodesis versus Arthroplasty on Patient Reported Outcomes

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Monique Chambers ◽  
MaCalus Hogan ◽  
Dukens LaBaze
Keyword(s):  
Patient Reported Outcomes ◽  
Surgical Intervention ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
First Metatarsophalangeal Joint ◽  
Significant Difference ◽  
Patient Reported ◽  
Outcome Scores ◽  
Vas Scores ◽  
End Stage

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Hallux rigidus is a degenerative disease of the first metatarsophalangeal joint. Severe, end-stage hallux rigidus can become debilitating with surgical intervention becoming necessary once conservative measures and shoe modifications have failed. Joint salvage procedures include metatarsal phalangeal (MTP) arthrodesis and MTP arthroplasty. The purpose of this study was to assess for differences in patient reported outcomes in two cohorts who underwent fusion or joint reconstruction. Methods: This study was a retrospective review of prospectively collected data of 385 patients from an academic medical institution. Patients who underwent surgical intervention from July 2015 to November 2016 were identified based on CPT codes for MTP arthrodesis (28750) and arthroplasty (28293). We extracted outcome scores including SF12-M, SF12-P, FAAM, and VAS scores. Exclusion criteria included poly-trauma, revision procedures, and lack of pre and post-operative outcome scores. Mann- Whitney t-test was performed using GraphPad Prism version 7.0b for Mac to compare procedure groups, with significance define by a p-value of 0.05. Results: A total of eighteen patients met the inclusion criteria, with 6 who underwent arthroplasty and 12 arthrodesis. The average age was 63.7 amongst the cohort, with a total of 16 female and 2 males. Patients who underwent arthrodesis had better outcomes across all parameters. When comparing preoperative and postoperative scores, arthrodesis patients showed greater improvement of SF12-M (arthrodesis 9 vs arthroplasty -2, p=0.05), and SF12-P (9 vs -16, respectively p=0.05) scores. Arthroplasty patients were more likely to have a decrease in their SF-12 scores. VAS scores and FAAM scores showed no statistical difference between the two cohorts. Postoperative VAS scores were worse in 33% of arthroplasty patients despite surgical intervention, compared to 10% of arthrodesis patients. Conclusion: Our results suggests that both procedures provide a statistically significant difference in pain with several patients having a Global Rate of Change that is “very much better”. However, fusion of the metatarsophalangeal joint results in improved pain and functional outcomes for patients with severe hallux rigidus. These findings are consistent with current reports in the literature, which are mostly case series reports. Larger studies are needed to provide appropriate power and better support the findings of this study.

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