Temporary Kirschner wire transfixation versus strapping dressing after second MTP joint realignment surgery: a...

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Biomechanical Analysis

Background:

• Second metatarsophalangeal (MTP) joint instability is a prevalent forefoot condition requiring surgical intervention.
• Realignment surgery for MTP instability often involves correction of associated deformities like claw toe.

Purpose of the Study:

• To compare the efficacy of temporary K-wire fixation (tKW) versus postoperative strapping (SD) in managing second MTP instability after surgical correction.
• To evaluate long-term outcomes regarding recurrence rates and patient-reported pain and function.

Main Methods:

• A 10-year follow-up study of 54 patients (62 interventions) undergoing MTP realignment surgery.
• Comparison of tKW versus noninvasive SD for postoperative management by two surgical teams.
• Assessment using AOFAS scores, VAS pain scores, Kaplan-Meier analysis for recurrence, and radiographic evaluation.

Main Results:

• The tKW group demonstrated a significantly higher survival rate without recurrence (93%) compared to the SD group (88%) (P < .001).
• No significant differences were observed in pre- to postoperative AOFAS or VAS pain scores between the two groups.

Conclusions:

• Temporary K-wire fixation is a superior method for maintaining alignment and reducing recurrence of second MTP subluxation postoperatively.
• Postoperative strapping dressing is less effective in preventing MTP joint subluxation recurrence compared to temporary K-wire fixation.