A multicentre retrospective cohort study of first metatarsophalangeal joint arthrodesis.
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Authors
Kannan, Sudhir
Bennett, Adam
Chong, Han Hong
Hilley, Alan
Coorsh, Jonathan
Murty, An
Townshend, David
Kakwani, Rajesh
Bhatia, Maneesh
Issue Date
2020
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Abstract
In this multicenter study, we evaluated commonly used methods of fixation and 2 methods of joint preparation for first metatarsophalangeal joint fusion, in terms of radiological union and revision rates. Included were 409 consecutive fusions in 385 patients. The overall union rate was 91.4% (34/409). About 29.4% (10/34) of our nonunions were symptomatic. Preoperative hallux valgus showed a statistically significant relation to nonunion (odds ratio [OR]=9.33, p=.017). Other potential contributing factors like gender (OR 1.9, p=.44), diabetes (OR=0, p=.99), steroid use (OR=2.07, p=.44), inflammatory arthritis (OR=0, p=.99), and smoking (OR=2.69, p=.34) did not attain statistical significance. Further, the methods of fixation like solid screws (OR=0, p=.99), plate (OR=3.6, p=.187), or cannulated screws (OR=0.09, p=.06) showed no correlation with incidence of nonunion. We compared 2 techniques of joint preparation and found no significant difference in union rates (chi-square=1.0426, p=.30). Our crude comparison of costs showed the average saving to the trust per year could be £33,442.50 by choosing screws over plates. To conclude, only hallux valgus had a statistically significant relation to nonunion. All other variables had no significant impact on the union. Solid screw seems to be economically the most viable option and a valid alternative.
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Citation
Kannan, S., Bennett, A., Chong, H.H. et al. (2020) A multicentre retrospective cohort study of first metatarsophalangeal joint arthrodesis. Journal of Foot and Ankle Surgery; 60 (3) : 436-439
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Journal of Foot and Ankle Surgery
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1067-2516