title: Endomedullary screw fixation for first metatarsophalangeal arthrodesis.
abstract: BACKGROUND
  The purpose of this study was to evaluate the clinical and radiological results in a group of patients who underwent first metatarsophalangeal joint arthrodesis with an endomedullary screw fixation technique (MPA-E).
  
  
  METHODS
  Between 2003 and 2009, 101 metatarsophalangeal arthrodesis were performed in 76 patients. There were 64 women and 12 men with an average age of 68 years. The indication for surgery was osteoarthritis with severe pain and functional limitation. Patients were evaluated radiologically and with the American Orthopaedic Foot & Ankle Society scoring system (AOFAS) at an average follow-up of 32 months (range, 24-92 months).
  
  
  RESULTS
  The success rate was 93%, with an increase of the average preoperative AOFAS from 38.5 points to 85.5 points postoperatively (P < .0001). The consolidation rate after radiological evaluation was 90.1%; there were 5 cases (5.0%) with asymptomatic nonunion and 5 cases (5.0%) with poor results because of symptomatic nonunion. Screw removal was needed in 4 feet (4.0%), and 2 feet (2.0%) had acute postoperative superficial infection. No implant cutout was observed.
  
  
  CONCLUSIONS
  The MPA-E technique provided consistent and high functional outcomes. This valid and effective alternative should be considered as an option for hallux metatarsophalangeal arthrodesis.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Atilio
authors.initials: A
authors.lastname: Migues
authors.forename: Juan
authors.initials: J
authors.lastname: Calvi
authors.forename: Pablo
authors.initials: P
authors.lastname: Sotelano
authors.forename: Marina
authors.initials: M
authors.lastname: Carrasco
authors.forename: Gastón
authors.initials: G
authors.lastname: Slullitel
authors.forename: Leonardo
authors.initials: L
authors.lastname: Conti
mesh_terms: D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D006214:Hallux / Q000601:surgery*; D020859:Hallux Rigidus / Q000601:surgery; D006215:Hallux Valgus / Q000601:surgery; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D010003:Osteoarthritis / Q000601:surgery; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: first metatarsophalangeal arthrodesis; fusion; hallux rigidus; hallux valgus