title: Corrective Realignment Arthrodesis of the First Tarsometatarsal Joint Without Wedge Resection.
abstract: Moderate to severe hallux valgus (HV) has traditionally been treated with a corrective osteotomy or a tarsometatarsal arthrodesis. Tarsometatarsal arthrodesis can be performed as a planar wedge resection or using a joint curettage technique. Little is known about whether adequate correction can be obtained with purely a joint curettage technique. The purpose of this study is to evaluate the corrective power of a first tarsometatarsal joint (TMTJ) arthrodesis using a nonplanar wedge curettage technique. A retrospective radiograph and chart review was performed on 99 consecutive patients (110 feet) who underwent a first TMTJ arthrodesis for primary HV correction utilizing a curettage technique. The radiographic measurements collected were the first intermetatarsal angle, HV angle, and tibial sesamoid position and were obtained at the following intervals: preoperative, immediate postoperative, and 6 months postoperative. In all, 91 patients (100 feet) qualified for statistical analysis. There was a significant decrease in all 3 measurements from the preoperative throughout the entire postoperative time period (P < .001). The authors demonstrate the ability to achieve significant angular correction with a joint curettage method for a tarsometatarsal arthrodesis.
  
  
  METHODS
  Therapeutic, Level IV: Case series.
authors.affiliation: CORE Institute, Phoenix, Arizona (JEM), Suburban Orthopadeics, Bartlett, IL (KSP) and Orthopedic Foot and Ankle Center, Westerville, Ohio (CFH).
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: McAlister
authors.affiliation: CORE Institute, Phoenix, Arizona (JEM), Suburban Orthopadeics, Bartlett, IL (KSP) and Orthopedic Foot and Ankle Center, Westerville, Ohio (CFH).
authors.forename: Kyle S
authors.initials: KS
authors.lastname: Peterson
authors.affiliation: CORE Institute, Phoenix, Arizona (JEM), Suburban Orthopadeics, Bartlett, IL (KSP) and Orthopedic Foot and Ankle Center, Westerville, Ohio (CFH) ofacresearch@orthofootankle.com.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Hyer
mesh_terms: D001174:Arthrodesis / Q000379:methods*; D001863:Bone Screws; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Lapidus; intermetatarsal angle; planar resection; tarsometatarsal fusion