title: Arthrodesis of the first metatarsophalangeal joint.
abstract: Arthrodesis has emerged as the primary salvage procedure for severe osteoarthritis of the first metatarsophalangeal (MTP) joint. Forty-three patients underwent arthrodesis of the first MTP joint with stabilization provided by either 2 crossed lag-screws or a dorsal plate and screws. First MTP joint arthrodesis was the primary procedure for 46 of the 54 treated feet. Joint surfaces were shaped into a ball-and-socket configuration to augment joint surface contact and facilitate alignment for arthrodesis. Postoperative care involved using a compressive bandage, a surgical shoe, and a cane, crutches, or a walker. Partial weight-bearing was allowed immediately after surgery. Few casts were used postoperatively. At a mean of 21.7 months (median, 13.5 months), 34 of the 43 patients completed a brief telephone survey about surgical outcomes. Radiographic measurements of intermetatarsal, hallux valgus, inclination, and dorsiflexion angles were made preoperatively and postoperatively. Mean time to fusion was 7.3 weeks; arthrodesis was successful for 50 of 52 feet (radiographs were missing for 2 of the 54 feet treated). Internal fixation devices were removed from 5 feet. Thirty (88.2%) of the 34 patients rated their result as excellent or good; the other 4 (11.8%) rated their result as poor.
authors.affiliation: Loyola University Medical Center, Maywood, Illinois, USA.
authors.forename: David T
authors.initials: DT
authors.lastname: Taylor
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Sage
authors.forename: Michael S
authors.initials: MS
authors.lastname: Pinzur
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis; D005260:Female; D020859:Hallux Rigidus / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome