Shortening of the first ray after first tarsometatarsal joint fusion: a cadaveric comparison between curettage versus planal resection

Potential shortening of the first ray is an important consideration when performing a first tarsometatarsal (TMTJ) fusion. However, no previous study has sought to directly quantify the resultant shortening after TMTJ fusion. The purpose of the present anatomic study was to directly assess and compa...

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Main Authors: Calvin J. Rushing, DPM, FACFAS, Bryon Mckenna, DPM, FACFAS, Travis Langen, DPM, FACFAS, Patrick E. Bull, DO, Gregory C. Berlet, MD, Christopher F. Hyer, DPM, MS, FACFAS, Christopher Ochner, PhD
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Foot & Ankle Surgery: Techniques, Reports & Cases
Subjects:
V
Online Access:http://www.sciencedirect.com/science/article/pii/S2667396723000733
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author Calvin J. Rushing, DPM, FACFAS
Bryon Mckenna, DPM, FACFAS
Travis Langen, DPM, FACFAS
Patrick E. Bull, DO
Gregory C. Berlet, MD
Christopher F. Hyer, DPM, MS, FACFAS
Christopher Ochner, PhD
author_facet Calvin J. Rushing, DPM, FACFAS
Bryon Mckenna, DPM, FACFAS
Travis Langen, DPM, FACFAS
Patrick E. Bull, DO
Gregory C. Berlet, MD
Christopher F. Hyer, DPM, MS, FACFAS
Christopher Ochner, PhD
author_sort Calvin J. Rushing, DPM, FACFAS
collection DOAJ
description Potential shortening of the first ray is an important consideration when performing a first tarsometatarsal (TMTJ) fusion. However, no previous study has sought to directly quantify the resultant shortening after TMTJ fusion. The purpose of the present anatomic study was to directly assess and compare shortening of the first ray using two joint preparation techniques (curettage, planal resection) for first TMTJ fusion. Ten pairs of matched lower extremity cadaver specimens were divided into two groups. Preoperative length assessments were performed at the first TMTJ dorsally and plantarly using a digital caliper. In Group 1, joint preparation for first TMTJ fusion was performed with curettage, whereas specimens in Group 2 underwent planal resection. Post-operative length assessments were repeated. All data was analyzed using two-tailed Students t-tests. Mean shortening of the first ray following curettage was 1.1 (range, 0.3 to 2.0) mm dorsally and 1.6 (range, 0.6 to 3.7) mm plantarly; while mean shortening following planal resection was 4.5 (range, 2.7 to 7.9) mm dorsally and 4.6 (range, 2.4 to 8.9) mm plantarly. The measured differences were statistically significant (p < 0.001, p = 0.001). Both curettage and planal resection resulted in shortening of the first ray after first TMTJ fusion. Planal resection resulted in significantly more shortening, which was also more variable. Surgeons performing first TMTJ fusions may consider curettage over planal resection to mitigate the risk of painful postoperative transfer metatarsalgia.
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spelling doaj.art-50942da52bfb4a88aa1c45d78f02233e2024-03-09T09:29:42ZengElsevierFoot & Ankle Surgery: Techniques, Reports & Cases2667-39672024-01-0141100335Shortening of the first ray after first tarsometatarsal joint fusion: a cadaveric comparison between curettage versus planal resectionCalvin J. Rushing, DPM, FACFAS0Bryon Mckenna, DPM, FACFAS1Travis Langen, DPM, FACFAS2Patrick E. Bull, DO3Gregory C. Berlet, MD4Christopher F. Hyer, DPM, MS, FACFAS5Christopher Ochner, PhD6Dallas Orthopedic and Shoulder Institute, Sunnyvale, TX, USA; Corresponding author: Calvin J. Rushing, DPM, FACFAS, Dallas Orthopedic and Shoulder Institute, 222 South Collins Road Suite 101, Sunnyvale 75182, TX.Thibodaux Regional, Thibodaux, LA, USAUnityPointHealth, Sioux, IA, USAOrthopedic Foot and Ankle Center, Worthington, OH, USAOrthopedic Foot and Ankle Center, Worthington, OH, USAOrthopedic Foot and Ankle Center, Worthington, OH, USAAventura Hospital and Medical Center, Adventura, FL, USAPotential shortening of the first ray is an important consideration when performing a first tarsometatarsal (TMTJ) fusion. However, no previous study has sought to directly quantify the resultant shortening after TMTJ fusion. The purpose of the present anatomic study was to directly assess and compare shortening of the first ray using two joint preparation techniques (curettage, planal resection) for first TMTJ fusion. Ten pairs of matched lower extremity cadaver specimens were divided into two groups. Preoperative length assessments were performed at the first TMTJ dorsally and plantarly using a digital caliper. In Group 1, joint preparation for first TMTJ fusion was performed with curettage, whereas specimens in Group 2 underwent planal resection. Post-operative length assessments were repeated. All data was analyzed using two-tailed Students t-tests. Mean shortening of the first ray following curettage was 1.1 (range, 0.3 to 2.0) mm dorsally and 1.6 (range, 0.6 to 3.7) mm plantarly; while mean shortening following planal resection was 4.5 (range, 2.7 to 7.9) mm dorsally and 4.6 (range, 2.4 to 8.9) mm plantarly. The measured differences were statistically significant (p < 0.001, p = 0.001). Both curettage and planal resection resulted in shortening of the first ray after first TMTJ fusion. Planal resection resulted in significantly more shortening, which was also more variable. Surgeons performing first TMTJ fusions may consider curettage over planal resection to mitigate the risk of painful postoperative transfer metatarsalgia.http://www.sciencedirect.com/science/article/pii/S2667396723000733V
spellingShingle Calvin J. Rushing, DPM, FACFAS
Bryon Mckenna, DPM, FACFAS
Travis Langen, DPM, FACFAS
Patrick E. Bull, DO
Gregory C. Berlet, MD
Christopher F. Hyer, DPM, MS, FACFAS
Christopher Ochner, PhD
Shortening of the first ray after first tarsometatarsal joint fusion: a cadaveric comparison between curettage versus planal resection
Foot & Ankle Surgery: Techniques, Reports & Cases
V
title Shortening of the first ray after first tarsometatarsal joint fusion: a cadaveric comparison between curettage versus planal resection
title_full Shortening of the first ray after first tarsometatarsal joint fusion: a cadaveric comparison between curettage versus planal resection
title_fullStr Shortening of the first ray after first tarsometatarsal joint fusion: a cadaveric comparison between curettage versus planal resection
title_full_unstemmed Shortening of the first ray after first tarsometatarsal joint fusion: a cadaveric comparison between curettage versus planal resection
title_short Shortening of the first ray after first tarsometatarsal joint fusion: a cadaveric comparison between curettage versus planal resection
title_sort shortening of the first ray after first tarsometatarsal joint fusion a cadaveric comparison between curettage versus planal resection
topic V
url http://www.sciencedirect.com/science/article/pii/S2667396723000733
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