Advertisement

Percutaneous First Metatarso-Phalangeal Joint Fusion

  • Thomas BauerEmail author
Chapter

Abstract

Fusion of the first metatarso-phalangeal (MTP1) joint is a useful procedure in forefoot surgery, and is still considered the gold standard for the management of severe painful hallux rigidus. Normal walking and running are possible after MTP1 fusion, as the interphalangeal (IP) joint develops compensatory hypermobility in dorsi-flexion.1,2 The main difficulty in this procedure is the 3D positioning of the arthrodesis that should be adapted to global foot anatomy, daily activity and shoe wearing habits of each patient.3–7 Another non specific difficulty is linked to the primary stability of the fusion depending on both technique for fusion site preparation and type of internal fixation.6–13 Several open or arthroscopically assisted procedures for MTP1 arthrodesis have been described, with fusion rates from 90% to 100%. The authors present a percutaneous procedure for MTP1 fusion with details on the surgical technique, first results and discussion of the benefits and indications.

Keywords

Hallux Valgus Primary Stability Metatarsal Head Full Weight Bearing Bone Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Mann RA, Oates JC. Arthrodesis of the first metatarsophalangeal joint. Foot Ankle. 1980;1:159–166.PubMedCrossRefGoogle Scholar
  2. 2.
    DeFrino PF, Brodsky JW, Pollo F et al. First metatarsophalangeal arthrodesis: a clinical, pedobarographic and gait analysis study. Foot Ankle Int. 2002;23:496–502.PubMedGoogle Scholar
  3. 3.
    Conti SF, Dhawan S. Arthrodesis of the first metatarsophalangeal and interphalangeal joints of the foot. Foot Ankle Clin N Am. 1996;1:33–53.Google Scholar
  4. 4.
    Harper MC. Positioning of the hallux for first metatarsophalangeal joint arthrodesis. Foot Ankle Int. 1997;18:827.PubMedCrossRefGoogle Scholar
  5. 5.
    Alexander IJ. Hallux metatarsophalangeal joint arthrodesis. In: Kitaoka HB, ed. Masters Techniques in Foot and Ankle Surgery. 2nd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2002:45–60.Google Scholar
  6. 6.
    Kelikian AS. Technical considerations in hallux metatarsophalangeal arthrodesis. Foot Ankle Clin N Am. 2005;10:167–190.CrossRefGoogle Scholar
  7. 7.
    Womack JW, Ishikawa SN. First metatarsophalangeal arthrodesis. Foot Ankle Clin N Am. 2009;14:43–50.CrossRefGoogle Scholar
  8. 8.
    Chana GS, Andrew TA, Cotterill CP. A simple method of arthrodesis of the first metatarsophalangeal joint. J Bone Joint Surg (Br). 1984;66:703–705.Google Scholar
  9. 9.
    Wu KK. Fusion of the metatarsophalangeal joint of the great toe with Herbert screws. Foot Ankle. 1993;14:165–169.PubMedCrossRefGoogle Scholar
  10. 10.
    Curtis MJ, Myerson M, Jinnah RH et al. Arthrodesis of the first metatarsophalangeal joint: a biomechanical study of internal fixation techniques. Foot Ankle Int. 1993;14:395–399.CrossRefGoogle Scholar
  11. 11.
    Rongstad DJ, Miller GJ, Vadergriend RA et al. A biomechanical comparison of four fixation methods of first metatarsophalangeal joint arthrodesis. Foot Ankle Int. 1994;15:415–419.PubMedCrossRefGoogle Scholar
  12. 12.
    Watson AD, Kelikian AS. Cost-effectiveness comparison of three methods of internal fixation for arthrodesis of the first metatarsophalangeal joint. Foot Ankle Int. 1998;19:304–310.PubMedCrossRefGoogle Scholar
  13. 13.
    Goucher NR, Coughlin MJ. Hallux metatarsophalangeal joint arthrodesis using dome-shaped reamers and dorsal plate fixation: a prospective study. Foot Ankle Int. 2006;27:869–876.PubMedGoogle Scholar
  14. 14.
    Coughlin MJ, Shurnas PS. Hallux rigidus: grading and long-term results of operative treatment. J Bone Joint Surg (Am). 2003;85A:2072–2088.Google Scholar
  15. 15.
    Flavin R, Stephens MM. Arthrodesis of the first metatarsophalangeal joint using a dorsal titanium contoured plate. Foot Ankle Int. 2004;25:783–787.PubMedGoogle Scholar
  16. 16.
    Brodsky JW, Passmore RN, Pollo FE et al. Functional outcome of arthrodesis of the first metatarsophalangeal joint using parallel screw fixation. Foot Ankle Int. 2005;26:140–146.PubMedGoogle Scholar
  17. 17.
    Yee G, Lau J. Current concepts review: hallux rigidus. Foot Ankle Int. 2008;29:637–646.PubMedCrossRefGoogle Scholar

Copyright information

© Springer London 2010

Authors and Affiliations

  1. 1.Ambroise Paré HospitalWest Paris University Department of Orthopaedic SurgeryBoulogneFrance

Personalised recommendations