Department of Orthopaedics, Bon Secours Hospital, Galway, Ireland; Department of Orthopaedics, Galway University Hospital, Galway, Ireland.
Department of Orthopaedics, Bon Secours Hospital, Galway, Ireland.
Foot Ankle Surg. 2024 Jul;30(5):411-416. doi: 10.1016/j.fas.2024.02.014. Epub 2024 Mar 2.
First metatarsophalangeal joint (MTPJ) arthrodesis is a commonly utilised procedure. In this study, the authors aim to explore functional outcomes of patients undergoing nonsynchronous bilateral first MTPJ arthrodesis under the care of a single surgeon using a compression screw/locking plate construct.
This is a prospectively collected, retrospectively analysed case series of fifty five patients who underwent bilateral nonsynchronous first MTPJ arthrodesis. Clinical and radiological outcomes were assessed preoperatively and at a minimum of two years postoperatively. Clinical outcomes were assessed using the Foot and Ankle Outcome Score (FAOS), the Self-Reported Foot and Ankle Score (SEFAS) and the Sports Questionnaire version 1 (SQ). Postoperative radiographs were used to assess evidence of union and compare both hallux valgus and intermetatarsal angles. Removal of hardware, revision surgery and correction of deformities were also recorded.
Fifty five patients were included in the study. There was statistically significant improvements in all five facets of the FAOS (p value < 0.05). The mean postoperative SEFAS was 45.1. In total, patients participated in thirteen different sporting activities. This represented 92 patient specific activities preoperatively and 104 postoperatively. The most common activities were walking, cycling and swimming. Overall, 94.5% (N = 52) of the cohort were satisfied with their return to sport while 98.2% (N = 54) would recommend bilateral first MTPJ arthrodesis. Mean reductions in hallux valgus angles and intermetatarsal angles were noted at 18.87 and 4.69 degrees respectively. There was one non-union in the cohort which required revision surgery. One patient required removal of hardware.
Bilateral first MTPJ arthrodesis is a safe and effective surgical option for patients with bilateral first MTPJ pathology. It has a high union rate, low complication rate and significantly improves clinical outcomes and allows patients reliably return to physical activities.
第一跖趾关节（MTPJ）融合术是一种常用的手术方法。在这项研究中，作者旨在探讨在一位外科医生的治疗下，使用加压螺钉/锁定板结构对双侧非同步第一 MTPJ 融合术患者的功能结果。
这是一项前瞻性收集、回顾性分析的 55 例双侧非同步第一 MTPJ 融合术患者的病例系列研究。术前和至少 2 年随访时评估临床和影像学结果。使用足部和踝关节结局评分（FAOS）、自我报告的足部和踝关节评分（SEFAS）和运动问卷 1 版（SQ）评估临床结果。术后 X 线片用于评估融合证据，并比较拇外翻和跖间角。还记录了内固定物取出、翻修手术和畸形矫正。
研究纳入 55 例患者。FAOS 的五个方面均有统计学显著改善（p 值<0.05）。术后平均 SEFAS 为 45.1。共有 13 种不同的运动项目，患者参与了这些项目。术前有 92 项患者特定活动，术后有 104 项。最常见的活动是步行、骑自行车和游泳。总体而言，94.5%（N=52）的患者对重返运动感到满意，98.2%（N=54）会推荐双侧第一 MTPJ 融合术。平均拇外翻角和跖间角分别减少 18.87 和 4.69 度。该队列中有 1 例不愈合，需要翻修手术。1 例患者需要取出内固定物。
双侧第一 MTPJ 融合术是治疗双侧第一 MTPJ 病变患者的一种安全有效的手术选择。它具有较高的融合率、较低的并发症率，并显著改善临床结果，使患者能够可靠地恢复体育活动。
