title: Evaluation of Fixation Techniques for Metatarsocuneiform Arthrodesis.
abstract: First metatarsocuneiform joint arthrodesis has been used in foot and ankle surgery for the treatment of hallux abductovalgus deformity, among other pedal pathologic entities. The goal of the present retrospective study was to compare the fusion rates and complications of an intraplate compression screw fixation, crossing solid core screw fixation, and a single interfragmentary screw with a simple locking plate. All procedures were performed by a single surgeon, and all patients received an identical postoperative protocol. A medical record review was performed of 147 evenly distributed surgical methods. All patients were non-weightbearing by protocol for 4 weeks. The patient covariates included sex, age, nicotine status, osteoporosis, and diabetes. These variables were balanced among the treatment groups and were noncontributory, with the exception of sex. Male patients had a 6 times greater odds of experiencing nonunion. The overall nonunion rate was 6.7%, with 4% symptomatic and requiring revision. The individual nonunion rates for each method were 2% for intraplate compression screw fixation, 5% for single interfragmentary screw with locking plate fixation, and 9% for crossing solid core screw fixation. None of the differences reached statistical significance. The corresponding hardware removal rates were 12%, 11%, and 0%.
authors.affiliation: Program Director, Podiatric Medicine and Surgery Residency Program, UnityPoint Health-Des Moines, Des Moines, IA; Attending Physician, The Iowa Clinic, West Des Moines, IA. Electronic address: ebarp@iowaclinic.com.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Barp
authors.affiliation: Resident, Podiatric Medicine and Surgery Residency Program, UnityPoint Health-Des Moines, Des Moines, IA.
authors.forename: John G
authors.initials: JG
authors.lastname: Erickson
authors.affiliation: Medical Researcher, UnityPoint Health-Des Moines, Des Moines, IA; Adjunct Faculty, Carver College of Medicine, University of Iowa, Iowa City, IA.
authors.forename: Hayden L
authors.initials: HL
authors.lastname: Smith
authors.affiliation: Resident, Podiatric Medicine and Surgery Residency Program, UnityPoint Health-Des Moines, Des Moines, IA.
authors.forename: Katrina
authors.initials: K
authors.lastname: Almeida
authors.affiliation: Podiatric Medical Student, Des Moines University, Des Moines, IA.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Millonig
mesh_terms: D000328:Adult; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D012737:Sex Factors; D017211:Treatment Failure
keywords: Lapidus; arthrodesis; bunionectomy; fixation; fusion; metatarsocuneiform arthrodesis; tarsometatarsal arthrodesis