First metatarsophalangeal joint percutaneous arthrodesis.

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Minimally Invasive Procedures

Background:

• First metatarsophalangeal (MTP1) joint arthrodesis is a common procedure for debilitating foot conditions.
• Traditional open techniques can involve significant soft tissue disruption and prolonged recovery.
• Percutaneous approaches offer a potential alternative with reduced morbidity.

Purpose of the Study:

• To describe a percutaneous technique for MTP1 joint fusion.
• To evaluate the preliminary clinical and radiographic outcomes of this minimally invasive procedure.
• To assess patient satisfaction and functional recovery following percutaneous MTP1 fusion.

Main Methods:

• A prospective series of 32 percutaneous MTP1 joint arthrodeses in 30 patients (mean age 66) were analyzed.
• The primary indications were symptomatic hallux rigidus or hallux rigido-valgus.
• Clinical outcomes were assessed using the AOFAS forefoot score; radiographic analysis focused on fusion and joint positioning.

Main Results:

• The mean AOFAS score improved significantly from 36/100 preoperatively to 80/100 postoperatively (p=0.02).
• Radiographic fusion was achieved in 31 out of 32 cases, with a mean postoperative dorsiflexion of 21°.
• Patient satisfaction was high, with 30 out of 32 patients reporting satisfaction or very high satisfaction; normal shoe wear was possible after a mean of 50 days.

Conclusions:

• Percutaneous MTP1 joint fusion is a simple, effective technique comparable to open procedures.
• The minimally invasive approach leads to significant functional improvement and high patient satisfaction.
• The technique is suitable for a wide range of indications, with contraindications limited to severe bone defects or osteoporosis.