First metatarsalphalangeal joint arthrodesis: evaluation of plate and screw fixation.
BACKGROUND
First metatarsalphalangeal joint (MTPJ) arthrodesis is a commonly performed procedure for the treatment of a variety of conditions affecting the hallux. There are several different methods to accomplish the fusion. We utilized a method incorporating a ball and cup preparation of the joint, followed by stabilization of the arthrodesis site utilizing the Accutrak congruent first MTPJ fusion set.


METHODS
We prospectively evaluated two hundred consecutive patients who underwent first MTPJ arthrodeses utilizing the Accutrak congruent first MTPJ fusion set. Patients were evaluated preoperatively, postoperatively, and at a final followup, utilizing the AOFAS forefoot scoring system.


RESULTS
Two hundred consecutive patients underwent first MTPJ arthrodeses by the same surgeon. All but three feet (230/233) (98.7%) went on to solidly fuse. Three of the patients did not fuse solidly. One patient broke two of the screws, and the other two patients did not have hardware failure. All patients dramatically improved their AOFAS scores compared with pre-surgical values. There were three minor hardware problems in the group of patients who solidly fused their joint.


CONCLUSIONS
We concluded that a solid first MTPJ fusion results in excellent function and pain relief. The Accutrak first MTPJ fusion system would appear to be an ideal implant system to accomplish a fusion because of its low profile, strength, and ease of use. Compared to other methods we have used, this procedure results in a very high rate of fusion, with minimal complications and excellent patient satisfaction.
Bennett
Gordon L
GL
Crystal Clinic, Inc., 3975 Embassy Parkway, Akron, OH 44333, USA. gbennortho@aol.com
Sabetta
James
J
D001174:Arthrodesis / Q000295:instrumentation*; D001860:Bone Plates; D001863:Bone Screws; D015331:Cohort Studies; D004868:Equipment Failure; D005260:Female; D017102:Fracture Healing; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008683:Metatarsophalangeal Joint; D008875:Middle Aged; D010027:Osteotomy; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome