Molded arthrodesis of the hallux metatarsophalangeal joint using the crossed-screw technique: surgical technique, results and functional outcomes.

BACKGROUND

We describe the surgical technique, results and functional outcomes of molded arthrodesis of hallux metatarsophalangeal (MTP) joint using crossed-screw fixation.

METHODS

23 Toes in 21 consecutive patients operated between September 2007 and January 2010 were included for the retrospective study. Average age was 60.0 years (range 31-84 years) with male female ratio being 3:4. Differential pitch cannulated crossed screw technique was used in all cases. At the latest follow-up, the radiological findings, the hallux-forefoot AOFAS scores and patient satisfaction questionnaires were used to assess outcomes.

RESULTS

Overall fusion rate was 91% with a mean hallux valgus angle of 13.6° (range 8-22°) and a mean dorsi-flexion angle of 25° (range 18-30°). Complication rate was 13% that included two superficial wound infections and one failed fusion that underwent a successful fusion after revision surgery. At a mean follow-up of 17 months (range 6-34 months), the mean AOFAS score was 79 (out of a maximum of 90). 92% of the patients were satisfied with the final outcome and 83% mentioned that they would have the procedure again.

CONCLUSIONS

Crossed-screw technique of arthrodesis of the first MTP joint is successful for relief of pain, allowing a high level of function and good patient satisfaction.