Clinical and radiological outcomes after arthrodesis of the first metatarsophalangeal joint
- 14 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Orthopaedics
- Vol. 45 (3), 711-719
- https://doi.org/10.1007/s00264-020-04807-3
Abstract
Purpose The main aim of this study was to investigate the correlation between radiographic findings and clinical outcomes following the first metatarsophalangeal (MTP) joint arthrodesis. Methods In a comparative retrospective study, on 46 patients (48 ft), the correlation between post-operative radiographic findings including hallux valgus angle (HVA) and first MTP dorsiflexion angle (MTPDA) and clinical outcomes including VAS pain, modified AOFAS hallux score, and FFI questionnaire were evaluated. Moreover, clinical outcomes were compared between cases with pre-operative diagnosis of first MTP inflammatory arthritis, hallux valgus, hallux varus, and grade 3 and 4 of hallux rigidus. The effect of first MTP arthrodesis on Meary’s angle and intermetatarsal angle (IMA) were found out. Results The mean age of the patients was 56.3 ± 9.1 (range, 29–69) years, including 42 (91.3%) females and 4 (8.7%) males. We had fusion rate of 97.9%, one asymptomatic nonunion case (2.1%). Totally, mean scores of modified AOFAS hallux score, FFI percentage, and VAS pain were 88.9 ± 12.6, 9.4 ± 16.5, and 1.23 ± 2.24, respectively. Hallux varus was associated with the most favourable outcomes; whereas, patients with first MTP arthritis got the worst outcome. Regression analysis test between clinical outcomes and HVA > 15° and first MTPDA >15° showed correlation coefficient of almost zero. No statistically significant differences were found between the clinical outcomes of grade 3 and 4 of hallux rigidus (p value of modified AOFAS hallux score, FFI percentage, and VAS pain: 0.879, 0.906, and 0.298, respectively). Mean of HVA and IMA reduction in 15 hallux valgus underwent first MTP fusion were 34.4° and 8.4°, respectively. Meary’s angle increased about 4° with statistically significant difference (p value 0.001). Conclusion Patients with first MTP fusion > 15° in coronal and transverse plans could have acceptable clinical outcomes. The clinical outcome of first MTP arthrodesis for grade 3 hallux rigidus is comparable with grade 4. First MTP fusion would have positive effect on IMA and Meary’s angle.Keywords
Funding Information
- Shiraz University of Medical Sciences (97-01-01-18677)
This publication has 37 references indexed in Scilit:
- First Metatarsophalangeal Joint Arthrodesis in the Treatment of Hallux ValgusClinics in Podiatric Medicine and Surgery, 2014
- Correlation of Dorsiflexion Angle and Plantar Pressure Following Arthrodesis of the First Metatarsophalangeal JointFoot & Ankle International, 2013
- Impact of first metatarsophalangeal joint osteoarthritis on health‐related quality of lifeArthritis Care & Research, 2012
- Avaliação do ângulo intermetatarsal após a artrodese da primeira articulação metatarsofalangeana para tratamento do hálux valgoRevista Brasileira de Ortopedia, 2012
- First Metatarsophalangeal Arthrodesis for Hallux RigidusFoot and Ankle Clinics, 2011
- Radiographic Outcomes Following Primary Arthrodesis of the First Metatarsophalangeal Joint in Hallux Abductovalgus DeformityThe Journal of Foot and Ankle Surgery, 2010
- Foot Function After Fusion of the First Metatarsophalangeal JointFoot & Ankle International, 2010
- Review of 107 Hallux MTP Joint Arthrodesis Using Dome-Shaped Reamers and a Stainless-Steel Dorsal PlateFoot & Ankle International, 2010
- First Metatarsophalangeal ArthrodesisFoot and Ankle Clinics, 2009
- Arthrodesis of the First Metatarsophalangeal JointFoot & Ankle, 1980