von Deimling C, Tondelli T, Brunner S, Andronic O, Graf AD. Achieving high union rates after first metatarsophalangeal joint arthrodesis: Radiographic outcomes and technical pitfalls. World J Orthop 2023; 14(6): 436-442 [PMID: 37377987 DOI: 10.5312/wjo.v14.i6.436]
Corresponding Author of This Article
Octavian Andronic, MD, Surgeon, Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngrünstrasse 42, Solothurn 4500, Switzerland. and_octavian@gmx.ch
Research Domain of This Article
Orthopedics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jun 18, 2023; 14(6): 436-442 Published online Jun 18, 2023. doi: 10.5312/wjo.v14.i6.436
Achieving high union rates after first metatarsophalangeal joint arthrodesis: Radiographic outcomes and technical pitfalls
Christian von Deimling, Timo Tondelli, Samuel Brunner, Octavian Andronic, Alexander David Graf
Christian von Deimling, Timo Tondelli, Samuel Brunner, Octavian Andronic, Alexander David Graf, Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Solothurn 4500, Switzerland
Author contributions: von Deimling C wrote the manuscript, performed the data acquisition; Tondelli T contributed to the statisics, data acquisition; Andronic O main responsibility for the study plan and design; Brunner S and Graf AD are senior author.
Institutional review board statement: This retrospective study was approved by the ethics commission board of northwest- and central- Switzerland and was conducted entirely at the authors institution: BASEC Nr 2021-00837.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: SB is in the advisory board of DePuy Synthes and receives advisory fees.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Octavian Andronic, MD, Surgeon, Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngrünstrasse 42, Solothurn 4500, Switzerland. and_octavian@gmx.ch
Received: December 28, 2022 Peer-review started: December 28, 2022 First decision: March 24, 2023 Revised: April 14, 2023 Accepted: May 15, 2023 Article in press: May 15, 2023 Published online: June 18, 2023 Processing time: 172 Days and 14 Hours
ARTICLE HIGHLIGHTS
Research background
Fusion of the first metatarsophalangeal joint (MTP1) is a common surgery performed to correct hallux rigidus, hallux rigidus et valgus and other painful degenerative diseases of the MTP1. High patient satisfaction and union rates have been reported in the literature with union rates ranging from 77% to 100%. In our own cohort we were also able to show high fusion rates.
Research motivation
Analyze our own cohort regarding union rate and radiologic outcome.
Research objectives
The main objective of this study as to asses our own patient collective regarding fusion rate and radiologic outcome including degree of correction.
Research methods
Out of the institution’s database every MTP1 arthrodesis that was executed between September 2011 and November 2020 was identified. The consecutive cohort consisted of 9 male patients and 62 female patients with 34 left and 38 right feet. Patients were followed and pre and postoperatively weight bearing radiographs (anterior-posterior, oblique and lateral) were analyzed for fusion rate and various radiologic parameters.
Research results
Of 71 patients showed a fused arthrodesis (98.6%) at the latest follow-up with one patient suffering from malunion. One patient finally fused after 18 months showing a delayed union while being asymptomatic throughout the whole period. The preoperative Hallux-valgus angle was in average 25.2 (range 14-64) with a correction down to 12 in average (range 2-27) while the preoperative intermetatarsal angle was 13.48 (range 4.5-24) with a postoperative correction to 9.2 in average (range 3.5-15). The preoperative MT1-P1 angle was 8.7 (range -28.05 to 55) with postoperative values of in average 16.89 (-4.05 to 34.5) which was already shown.
Research conclusions
We were able to show that with our surgical technique, high union rates (98%) can be achieved using a compression screw and a dorsal variable-angle locking plate to treat degenerative diseases of the MTP1 even in diabetic and smoking patients.
Research perspectives
Future studies should particularly correlate radiological data with clinical scores to confirm their clinical relevance and superiority.
