[Arthrodesis of the first metatarsophalangeal joint].
Arthrodesis of the first metatarsophalangeal joint is a useful technique for the surgical treatment of hallux rigidus, complicated hallux valgus and rheumatoid forefoot deformity, and for revisions following resection arthroplasty or explantation of a prosthesis combined with interposition of a tricortical bone graft. In primary operations, good or excellent results can be achieved in 80-90% of patients. The articular surface and any exostoses or osteophytes are first resected aiming for a 15-30 degrees extension of the metatarsophalangeal angle and a 5-15 degrees valgus angle. Pseudarthroses occur in 10-13% of arthrodeses stabilized with screws or k-wires. When using a plate for fixation, the rate of pseudarthroses is below 6%. Only a small number of pseudarthroses require revision surgery. Up to 15% of patients develop mostly asymptomatic degeneration of the interphalangeal joint of the hallux.
Suckel
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A
Orthopädische Klinik und Poliklinik, Universität, Tübingen. Andreas.Suckel@med.uni-tuebingen.de
Wülker
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N
D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods*; D005530:Foot Deformities / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D007593:Joint Instability / Q000517:prevention & control / Q000601:surgery; D008683:Metatarsophalangeal Joint / Q000002:abnormalities* / Q000601:surgery*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods