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Updated: May 7, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Comparative study of Lapidus bunionectomy using different osteosynthesis methods.

N Gutteck1, D Wohlrab, A Zeh

  • 1Department for Orthopaedics and Traumatology, Martin Luther University, Halle Wittenberg, Magdeburger Straße 22, 06112 Halle, Germany.

Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons
|October 8, 2013
PubMed
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Fusion of the first tarsometatarsal (TMT I) joint is a hallux valgus treatment. Mediodorsal plate placement during TMT-I arthrodesis showed more adverse effects than plantar plate fixation.

Area of Science:

  • Orthopaedic Surgery
  • Foot and Ankle Surgery

Background:

  • Hallux valgus treatment often involves first tarsometatarsal (TMT I) joint fusion.
  • The Lapidus bunionectomy has a pseudarthrosis rate of up to 12% compared to distal procedures.

Purpose of the Study:

  • To compare outcomes of TMT-I arthrodesis using an interfragmentary screw with either a plantar plate or a dorsomedial locking plate.
  • To evaluate the rate of undesirable effects associated with different plate positions.

Main Methods:

  • Prospective clinical and radiological examinations were conducted preoperatively, at six weeks, and one year postoperatively.
  • American Orthopaedic Foot and Ankle Society (AOFAS) scores and Visual Analogue Pain Scale (VAS) were assessed preoperatively and at 12 months.
  • Comparison of outcomes between plantar plate fixation and dorsomedial locking plate fixation for TMT-I arthrodesis.
Keywords:
ArthrodesisHallux valgusLapidus bunionectomyTarsometatarsal joint

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Main Results:

  • A significantly higher rate of undesirable effects was observed with mediodorsal plate positioning.
  • Clinical and radiological outcomes were evaluated to compare the two fixation methods.

Conclusions:

  • Plantar plate fixation may be associated with fewer undesirable effects compared to mediodorsal plate placement in TMT-I arthrodesis.
  • Further research is needed to optimize surgical techniques for TMT-I joint fusion in hallux valgus treatment.