title: Comparison of Hallux Interphalangeal Joint Arthrodesis Fixation Techniques: A Retrospective Multicenter Study.
abstract: Few studies have investigated the complications that occur after hallux interphalangeal joint arthrodesis. The present study evaluated complications in 152 patients aged 18 to 80 years from 2005 to 2012 from 4 different academic institutions after hallux interphalangeal joint arthrodesis. Overall, 65.8% of the patients had ≥1 complication. Infections occurred in 16.5%, dehiscence in 12.5%, and reoperations in 27.0%. The clinical nonunion rate was ≥17.8%, and the radiographic nonunion rate was ≥13.8%. After logistic regression analysis, only the study site and peripheral neuropathy were associated with having ≥1 complication (p < .01 and p < .05, respectively). Single screw fixation compared with other fixation did not have a statistically significant influence on the postoperative complications. However, when fixation was expanded to 4 categories, single screw fixation had lower infection and reoperation rates than either crossed Kirschner wires or other fixation category but not compared with crossed screws on multivariate logistic regression analysis. Although additional studies are warranted, the findings from the present study might aid in both the prognosis of complications and the support of the use of a single screw over crossed Kirchner wire fixation in hallux interphalangeal joint arthrodesis.
authors.affiliation: Staff, Central Texas Veterans Affairs Health Care System; and Staff, Baylor Scott and White Health, Temple, TX. Electronic address: jthorud@sw.org.
authors.forename: Jakob C
authors.initials: JC
authors.lastname: Thorud
authors.affiliation: Third Year Resident, Baylor Scott and White Health, Central Texas Veterans Affairs Health Care System, Texas A&M Health Science Center, Temple, TX.
authors.forename: Tyler
authors.initials: T
authors.lastname: Jolley
authors.affiliation: Associate Professor, Department of Surgery, Texas A&M Health Science Center College of Medicine; Chief, Section of Podiatry, Central Texas Veterans Affairs Health Care System; and Staff, Baylor Scott and White Health, Temple, TX.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Shibuya
authors.affiliation: Fellow, University of Arizona College of Medicine, Southern Arizona Limb Salvage Alliance, Tuscan, AZ.
authors.forename: Eric
authors.initials: E
authors.lastname: Lew
authors.affiliation: Physician, Private Practice, Mesquite, TX.
authors.forename: Matthew
authors.initials: M
authors.lastname: Britt
authors.affiliation: Third-Year Resident, University of North Texas Health Science Center/John Peter Smith Hospital, Fort Worth, TX.
authors.forename: Ted
authors.initials: T
authors.lastname: Butterfield
authors.affiliation: Dean, Kent State University College of Podiatric Medicine, Independence, OH.
authors.forename: Alan
authors.initials: A
authors.lastname: Boike
authors.affiliation: Chief, Foot and Ankle Services, Mercy Health Foot and Ankle/HealthSpan Physicians, Cleveland Heights, OH.
authors.forename: Mark
authors.initials: M
authors.lastname: Hardy
authors.affiliation: Director, Hunt Regional Healthcare Podiatry Residency Program, Hunt Regional Healthcare, Greenville, TX.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Brancheau
authors.affiliation: Associate Professor, University of North Texas Health Science Center/John Peter Smith Hospital, Fort Worth, TX.
authors.forename: Travis
authors.initials: T
authors.lastname: Motley
authors.affiliation: Assistant Professor, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Jupiter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000379:methods*; D001863:Bone Screws; D001864:Bone Wires; D005260:Female; D005500:Follow-Up Studies; D006214:Hallux / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: fusion; great toe; intramedullary screw