title: Reduction of the intermetatarsal angle after first metatarsal phalangeal joint arthrodesis: a systematic review.
abstract: Arthrodesis of the first metatarsophalangeal joint (MTPJ) has commonly been used for the treatment of a variety of first MTPJ disorders, including hallux valgus. We undertook a systematic review of the electronic databases and other relevant sources to identify material relating to the reduction of the first intermetatarsal angle (IMA) after first MTPJ arthrodesis. Fifteen studies with a total of 701 first MTPJ arthrodesis procedures were identified that met the inclusion criteria. Our results showed the mean preoperative IMA was 13.74° and the mean postoperative IMA was 9.38°, for a mean change in the IMA of 4.36°. The data were analyzed further in 2 subsets. The first subset included 8 studies (434 procedures) that reported a mean preoperative IMA of less than 15°. The mean change in the IMA in this group was 3.70°. The second subset included 7 studies (267 procedures) that reported a mean preoperative IMA of greater than 15°. The mean change in the IMA in this group was 5.42°. The results of the present systematic review have confirmed that a significant reduction of the first IMA can be achieved by first MTPJ arthrodesis alone and that additional procedures to correct the IMA will not be necessary.
authors.affiliation: UnityPoint Clinic Foot and Ankle, Trinity Regional Medical Center; Adjunct Professor, Des Moines University College of Podiatric Medicine and Surgery, Fort Dodge, IA. Electronic address: daytonp@me.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Dayton
authors.affiliation: Assistant Professor, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA.
authors.forename: Mindi
authors.initials: M
authors.lastname: Feilmeier
authors.affiliation: Resident, UnityPoint Clinic Foot and Ankle, Trinity Regional Medical Center, Fort Dodge, IA.
authors.forename: Brian
authors.initials: B
authors.lastname: Hunziker
authors.affiliation: Podiatric Medical Student, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA.
authors.forename: Todd
authors.initials: T
authors.lastname: Nielsen
authors.affiliation: Assistant Professor, Des Moines University College of Health Sciences, Des Moines, IA.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Reimer
mesh_terms: D001174:Arthrodesis / Q000379:methods*; D033023:Foot Joints; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008682:Metatarsal Bones / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000601:surgery*
keywords: bunion; fusion; hallux valgus; surgery