Klinika Ortopedii, Traumatologii Narządu Ruchu i Chirurgii Ręki UCK w Gdańsku, Polska / Department of Orthopaedics, Musculoskeletal Traumatology and Hand Surgery, University Clinical Centre, Gdańsk, Poland.
II Klinika Ortopedii i Traumatologii Narządu Ruchu, Gdańskiego Uniwersytetu Medycznego, Polska / 2nd Department of Orthopaedics and Musculoskeletal Traumatology, Medical University of Gdańsk, Poland.
Ortop Traumatol Rehabil. 2021 Jun 30;23(3):205-212. doi: 10.5604/01.3001.0014.9256.
Arthrodesis of the first metatarsophalangeal joint (MTP-1) is a recognized and effective procedure in advanced osteoarthritis of this joint. Fixation with a dorsal plate and a compression screw has been described as the most stable. Nevertheless, the frequency of revision procedures after MTP-1 arthrodesis has been reported to exceed 10% in some reports. The need for revision surgery is mostly related to the fixation material used and concern both its destabilization and a conflict between the implants and soft tissues. Therefore, there is still scope for developing new stabilization methods for the MTP-1 joint.
With the approval of the relevant Bioethics Committee, we conducted a pilot clinical trial to assess the safety and efficacy of the use of the medial plate in MTP-1 fusion. Twenty patients qualified for treatment due to osteoarthritis of the metatarsophalangeal joint were evaluated. The clinical results of the surgical treatment were assessed at least one year after the surgery.
The mean AOFAS MTP-IP score increased from 35.29±18.76 to 75.59±12.15. The mean EFAS score in-creased from 9.24±5.73 to 18.35±5.66. Pain level as per a VAS decreased from 6.24±1.48 to 1.59±2.58. A total of 18 patients were satisfied with the procedure, with the remaining 2 patients reporting the result as unsatisfactory. Two revision procedures were performed, both due to migration of the fixation material.
第一跖趾关节（MTP-1）融合术是治疗该关节晚期骨关节炎的一种公认且有效的方法。背侧钢板和加压螺钉固定被认为是最稳定的方法。然而，一些报道称，MTP-1 融合术后的翻修手术频率超过 10%。需要进行翻修手术的主要原因与所使用的固定材料有关，既包括其不稳定性，也包括植入物与软组织之间的冲突。因此，仍有必要开发新的 MTP-1 关节稳定方法。
在获得相关伦理委员会批准的情况下，我们进行了一项试点临床试验，以评估内侧钢板在 MTP-1 融合中的安全性和有效性。共有 20 名因跖趾关节骨关节炎而符合治疗条件的患者接受了评估。术后至少 1 年对手术治疗的临床结果进行了评估。
AOFAS MTP-IP 评分从 35.29±18.76 增加到 75.59±12.15，EFAS 评分从 9.24±5.73 增加到 18.35±5.66，VAS 疼痛评分从 6.24±1.48 降低至 1.59±2.58。18 名患者对手术结果非常满意，2 名患者不满意。共进行了 2 次翻修手术，均因固定材料移位所致。
