Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review
• Purpose: A systematic review to determine the effect of different types of joint preparation, joint fixation, and postoperative weight-bearing protocols on non-union frequency in first metatarsophalangeal joint (MTPJ) arthrodesis in patients with moderate-to-severe hallux valgus. • Material and m...
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| Format: | Article |
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Bioscientifica
2023-03-01
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| Series: | EFORT Open Reviews |
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| Online Access: | https://eor.bioscientifica.com/view/journals/eor/8/3/EOR-22-0134.xml |
| _version_ | 1797870190060371968 |
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| author | Wout Füssenich Gesine H Seeber Julian R Zwoferink Matthijs P Somford Martin Stevens |
| author_facet | Wout Füssenich Gesine H Seeber Julian R Zwoferink Matthijs P Somford Martin Stevens |
| author_sort | Wout Füssenich |
| collection | DOAJ |
| description | • Purpose: A systematic review to determine the effect of different types of joint preparation, joint fixation, and postoperative weight-bearing protocols on non-union frequency in first metatarsophalangeal joint (MTPJ) arthrodesis in patients with moderate-to-severe hallux valgus.
• Material and methods: A systematic literature search (PubMed and EMBASE), adhering to PRISMA guidelines. Data on MTPJ preparation, fixation, weight-bearing, and non-union in patients with moderate-to-severe hallux valgus were collected. Quality assessment was performed using the Coleman Methodology Score.
• Results: Sixteen studies (934 feet) were included, generally of medium quality. Overall nonunion rate was 7.7%. At 6.3%, convex/concave joint preparation had the lowest non-union rate vs 12.2% for hand instruments and 22.2% for planar cuts. Non-union of 2.8% was found for joint fixation with a plate combined with a lag screw vs 6.5% for plate fixation, 11.1% for crossed screw fixation, and 12.5% for a plate with a cross plate compression screw. A 5.1% non-union frequency was found following postoperative full weight-bearing on a flat shoe vs 9.3% for full weight-bearing on a heel weight-bearing shoe and 0% for a partial weight-bearing regimen.
• Conclusion: Based on medium-quality papers, joint preparation with convex/concave reamers and joint fixation with a plate using a lag screw show the lowest non-union rate. Full postoperative weight-bearing in a stiff-soled postoperative shoe is safe and not associated with non-union vs a more protective load-bearing regimen. Further research should focus on larger sample sizes, longer follow-ups, and stronger study designs. |
| first_indexed | 2024-04-10T00:24:29Z |
| format | Article |
| id | doaj.art-a2001912b9a4447e8a5761570e69dd23 |
| institution | Directory Open Access Journal |
| issn | 2058-5241 |
| language | English |
| last_indexed | 2024-04-10T00:24:29Z |
| publishDate | 2023-03-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | EFORT Open Reviews |
| spelling | doaj.art-a2001912b9a4447e8a5761570e69dd232023-03-15T12:14:47ZengBioscientificaEFORT Open Reviews2058-52412023-03-0183101109https://doi.org/10.1530/EOR-22-0134Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic reviewWout Füssenich0Gesine H Seeber1Julian R Zwoferink2Matthijs P Somford3Martin Stevens4Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The NetherlandsDepartment of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands• Purpose: A systematic review to determine the effect of different types of joint preparation, joint fixation, and postoperative weight-bearing protocols on non-union frequency in first metatarsophalangeal joint (MTPJ) arthrodesis in patients with moderate-to-severe hallux valgus. • Material and methods: A systematic literature search (PubMed and EMBASE), adhering to PRISMA guidelines. Data on MTPJ preparation, fixation, weight-bearing, and non-union in patients with moderate-to-severe hallux valgus were collected. Quality assessment was performed using the Coleman Methodology Score. • Results: Sixteen studies (934 feet) were included, generally of medium quality. Overall nonunion rate was 7.7%. At 6.3%, convex/concave joint preparation had the lowest non-union rate vs 12.2% for hand instruments and 22.2% for planar cuts. Non-union of 2.8% was found for joint fixation with a plate combined with a lag screw vs 6.5% for plate fixation, 11.1% for crossed screw fixation, and 12.5% for a plate with a cross plate compression screw. A 5.1% non-union frequency was found following postoperative full weight-bearing on a flat shoe vs 9.3% for full weight-bearing on a heel weight-bearing shoe and 0% for a partial weight-bearing regimen. • Conclusion: Based on medium-quality papers, joint preparation with convex/concave reamers and joint fixation with a plate using a lag screw show the lowest non-union rate. Full postoperative weight-bearing in a stiff-soled postoperative shoe is safe and not associated with non-union vs a more protective load-bearing regimen. Further research should focus on larger sample sizes, longer follow-ups, and stronger study designs.https://eor.bioscientifica.com/view/journals/eor/8/3/EOR-22-0134.xmlarthrodesisfusionmtp1first mtpjfirst metatarsophalangeal jointhallux valgusnon-unionpseudoarthrosis |
| spellingShingle | Wout Füssenich Gesine H Seeber Julian R Zwoferink Matthijs P Somford Martin Stevens Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review EFORT Open Reviews arthrodesis fusion mtp1 first mtpj first metatarsophalangeal joint hallux valgus non-union pseudoarthrosis |
| title | Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review |
| title_full | Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review |
| title_fullStr | Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review |
| title_full_unstemmed | Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review |
| title_short | Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review |
| title_sort | non union incidence of different joint preparation types joint fixation techniques and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate to severe hallux valgus a systematic review |
| topic | arthrodesis fusion mtp1 first mtpj first metatarsophalangeal joint hallux valgus non-union pseudoarthrosis |
| url | https://eor.bioscientifica.com/view/journals/eor/8/3/EOR-22-0134.xml |
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