First Metatarsophalangeal Joint Arthrodesis Using an Intraosseous Post and Lag Screw With Immediate Bearing of Weight.
Arthrodesis is the gold standard procedure for advanced arthrosis of the first metatarsophalangeal joint. Having a strong construct is preferable for allowing immediate bearing of weight, which facilitates patient rehabilitation. Plate and screw fixation is currently in favor but can lead to prominent metalware necessitating removal. The aim of this study is to report the results of a series of 54 first metatarsophalangeal joint arthrodeses performed in 52 patients treated with an implant composed of an intraosseous post and lag screw. All of the patients had a minimum follow-up of 1 year, and the indication for the surgery was end-stage hallux rigidus in 44 (81.5%) feet, severe hallux valgus in 8 (14.8%) feet, and rheumatoid arthritis in 2 (3.7%) feet. Arthrodesis was achieved in 52 (96.3%) feet at a mean of 61 ± 16 (range 39 to 201) days with nonunion observed in 2 (3.7%) feet; neither of the 2 patients had known risk factors. Metalware impinging on soft tissues necessitating removal was observed in 3 (5.6%) feet, and there were no cases of loss of position or implant breakage. The mean Manchester-Oxford Foot Questionnaire score improved from 46.4 ± 13.3 to 18.4 ± 9.4 (p < .001) at latest follow-up. In conclusion, our results suggest the intraosseous post and lag screw device was safe and effective, and it can be considered an alternative method of stabilizing the first metatarsophalangeal joint when undertaking arthrodesis surgery.
['Patel|Shelain|S|', 'Garg|Parag|P|', 'Fazal|M Ali|MA|', 'Ray|Pinak S|PS|']
D000328:Adult D000368:Aged D001174:Arthrodesis D001858:Bone Nails D001863:Bone Screws D005260:Female D005500:Follow-Up Studies D020859:Hallux Rigidus D006801:Humans D008297:Male D008683:Metatarsophalangeal Joint D008875:Middle Aged D011859:Radiography D016059:Range of Motion, Articular D012189:Retrospective Studies D013997:Time Factors D016474:Weight-Bearing
metatarsophalangeal joint arthrodesis hallux fixation device weightbearing