Evaluation of Fixation Techniques for Metatarsocuneiform Arthrodesis

Area of Science:

• Foot and Ankle Surgery
• Orthopedic Surgery
• Biomechanics

Background:

• First metatarsocuneiform (MTC) joint arthrodesis is a common procedure in foot and ankle surgery.
• It is utilized for conditions such as hallux abductovalgus deformity.
• Evaluating fixation techniques is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To compare fusion rates and complications of three distinct fixation methods for first MTC joint arthrodesis.
• To analyze the influence of patient covariates on surgical outcomes.
• To identify the most effective fixation technique regarding nonunion and hardware complications.

Main Methods:

• Retrospective review of 147 patients undergoing first MTC joint arthrodesis by a single surgeon.
• Comparison of three fixation techniques: intraplate compression screw, crossing solid core screw, and single interfragmentary screw with locking plate.
• Standardized postoperative protocol including 4 weeks non-weightbearing.

Main Results:

• Overall nonunion rate was 6.7%, with 4% requiring revision surgery.
• Individual nonunion rates: 2% (intraplate), 5% (interfragmentary screw/locking plate), 9% (crossing screw). No statistical significance was found.
• Male patients had a 6-fold increased odds of nonunion. Hardware removal rates varied: 12%, 11%, and 0% respectively.

Conclusions:

• No single fixation method demonstrated statistically superior fusion rates for first MTC joint arthrodesis.
• Patient sex is a significant factor influencing nonunion risk.
• Further research may be warranted to optimize fixation strategies and mitigate nonunion in specific patient populations.