Arthrodesis of the First Metatarsophalangeal Joint Utilizing a Chamfered compression screw and low-profile dorsal locking plate
Background: First Metatarsophalanageal Joint (MTPJ) fusion is a reliable treatment for end stage arthritis of the 1st MTPJ and is still considered the gold standard. Historically non-union and hardware removal rates are in the 5–10% range which can lead to need for revision surgery. We describe a te...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Foot & Ankle Surgery: Techniques, Reports & Cases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667396722000921 |
| _version_ | 1797870541269368832 |
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| author | Tyler Tewilliager, DPM, AACFAS Kevin Lutta, MD Alan Ng, DPM, FACFAS |
| author_facet | Tyler Tewilliager, DPM, AACFAS Kevin Lutta, MD Alan Ng, DPM, FACFAS |
| author_sort | Tyler Tewilliager, DPM, AACFAS |
| collection | DOAJ |
| description | Background: First Metatarsophalanageal Joint (MTPJ) fusion is a reliable treatment for end stage arthritis of the 1st MTPJ and is still considered the gold standard. Historically non-union and hardware removal rates are in the 5–10% range which can lead to need for revision surgery. We describe a technique utilizing a chamfered headless compression screw and low profile dorsal locking plate to evaluate hardware removal rates and time to osseous union. Methods: Retrospective radiographic review performed on 43 1st MTPJ fusions utilizing a chamfered headless compression screw and low profile dorsal locking plate. Patients were evaluated for time to union (days), complications, need for hardware removal, and non-union rates. Results: We demonstrated that the fusion rate at a mean time of 76.3 days was 93.1 percent. Three patients underwent revision surgery for non-union while no patients required revision surgery for painful hardware. Complications included 4 superficial infections that cleared with oral antibiotics, 1 contact dermatitis, 1 asymptomatic hardware lucency and 3 non-unions Conclusion: We found our technique utilizing a chamfered compression screw and low profile dorsal locking plate provides satisfactory union rates and low rates of hardware pain which may decrease the necessity for additional surgical procedures. |
| first_indexed | 2024-04-10T00:30:09Z |
| format | Article |
| id | doaj.art-b1ee0fac7a86413fa378d08906854239 |
| institution | Directory Open Access Journal |
| issn | 2667-3967 |
| language | English |
| last_indexed | 2024-04-10T00:30:09Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Foot & Ankle Surgery: Techniques, Reports & Cases |
| spelling | doaj.art-b1ee0fac7a86413fa378d089068542392023-03-15T04:29:18ZengElsevierFoot & Ankle Surgery: Techniques, Reports & Cases2667-39672023-01-0131100235Arthrodesis of the First Metatarsophalangeal Joint Utilizing a Chamfered compression screw and low-profile dorsal locking plateTyler Tewilliager, DPM, AACFAS0Kevin Lutta, MD1Alan Ng, DPM, FACFAS2Reconstructive Foot and Ankle Surgery Fellow, Advanced Orthopedics and Sports Medicine Specialists, Denver, CO, United States; Corresponding author.Orthopedic Foot and Ankle Surgeon, OrthoVirgina, Fairfax,VA, United StatesFellowship Director, Rocky Mountain Reconstructive Foot and Ankle Surgery Fellowship, Advanced Orthopedics and Sports Medicine Specialists, Denver, CO, United StatesBackground: First Metatarsophalanageal Joint (MTPJ) fusion is a reliable treatment for end stage arthritis of the 1st MTPJ and is still considered the gold standard. Historically non-union and hardware removal rates are in the 5–10% range which can lead to need for revision surgery. We describe a technique utilizing a chamfered headless compression screw and low profile dorsal locking plate to evaluate hardware removal rates and time to osseous union. Methods: Retrospective radiographic review performed on 43 1st MTPJ fusions utilizing a chamfered headless compression screw and low profile dorsal locking plate. Patients were evaluated for time to union (days), complications, need for hardware removal, and non-union rates. Results: We demonstrated that the fusion rate at a mean time of 76.3 days was 93.1 percent. Three patients underwent revision surgery for non-union while no patients required revision surgery for painful hardware. Complications included 4 superficial infections that cleared with oral antibiotics, 1 contact dermatitis, 1 asymptomatic hardware lucency and 3 non-unions Conclusion: We found our technique utilizing a chamfered compression screw and low profile dorsal locking plate provides satisfactory union rates and low rates of hardware pain which may decrease the necessity for additional surgical procedures.http://www.sciencedirect.com/science/article/pii/S2667396722000921 |
| spellingShingle | Tyler Tewilliager, DPM, AACFAS Kevin Lutta, MD Alan Ng, DPM, FACFAS Arthrodesis of the First Metatarsophalangeal Joint Utilizing a Chamfered compression screw and low-profile dorsal locking plate Foot & Ankle Surgery: Techniques, Reports & Cases |
| title | Arthrodesis of the First Metatarsophalangeal Joint Utilizing a Chamfered compression screw and low-profile dorsal locking plate |
| title_full | Arthrodesis of the First Metatarsophalangeal Joint Utilizing a Chamfered compression screw and low-profile dorsal locking plate |
| title_fullStr | Arthrodesis of the First Metatarsophalangeal Joint Utilizing a Chamfered compression screw and low-profile dorsal locking plate |
| title_full_unstemmed | Arthrodesis of the First Metatarsophalangeal Joint Utilizing a Chamfered compression screw and low-profile dorsal locking plate |
| title_short | Arthrodesis of the First Metatarsophalangeal Joint Utilizing a Chamfered compression screw and low-profile dorsal locking plate |
| title_sort | arthrodesis of the first metatarsophalangeal joint utilizing a chamfered compression screw and low profile dorsal locking plate |
| url | http://www.sciencedirect.com/science/article/pii/S2667396722000921 |
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