title: 1st metatarsophalangeal joint fusion: A comparison of non-union and gender differences between locking and non-locking plating systems.
abstract: BACKGROUND
  Fusion of the first metatarsophalangeal joint (1st MTPJ) is a common surgical procedure used to treat a variety of diseases and deformities of the forefoot. Fixation methods vary and typically fusion rates are good.
  
  
  OBJECTIVE
  The objectives of the study are to demonstrate whether there is any advantage to using locking as opposed to non-locking plates for 1st MTPJ fusion. Additionally the study aims to determine whether there is any difference in non-union rates according to gender.
  
  
  METHODS
  One hundred and seventy two consecutive 1st MTPJ fusions were performed for 153 patients. 40 patients (23%) were male and 132 (77%) female. Twenty patients received Hallu-fix™ plates, 76 Charlotte™ plates and 76 Anchorage™ plates. Postoperative radiographs were reviewed for non-union. Failure rates were compared using Fisher's exact tests (p=0.05).
  
  
  RESULTS
  Twelve (6.9%) non-unions were identified. The difference in failure rates between all systems was not statistically significant. However, the difference in fusion rates between males (17.5%) and females (3.8%) was significant.
  
  
  CONCLUSIONS
  This study finds that 1st MTPJ fusion is an effective method to treat diseases of the 1st MTPJ. Locking plates may offer better fusion rates than their non-locking counterparts. This is especially evident in male patients.
authors.affiliation: Royal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, Merseyside, United Kingdom. Electronic address: E_bass@hotmail.co.uk.
authors.forename: Edward James
authors.initials: EJ
authors.lastname: Bass
authors.affiliation: Royal Liverpool and Broadgreen University Hospital Trust, Prescot Street, Liverpool L7 8XP, Merseyside, United Kingdom.
authors.forename: Siva Prasad
authors.initials: SP
authors.lastname: Sirikonda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000295:instrumentation*; D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006214:Hallux / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: First; Fusion; Joint; Locking; Metatarsophalangeal; Non-locking