Related Experiment Video
Updated: Mar 6, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Percutaneous First Metatarsophalangeal Joint Arthrodesis With Single‑Screw Fixation: Technique and 24‑Month Clinical
Théopol Dardenne1, Héloïse Bogas Droy1, Naveen Nara2
1Department of Orthopaedic Surgery and Traumatology, University Hospital Center (CHU) of Bordeaux, Bordeaux, France.
Background:
First metatarsophalangeal (MTP1) joint arthrodesis is considered the gold standard for the treatment of advanced hallux rigidus and severe arthritic hallux valgus. Although open techniques are widely used, they are associated with a risk of postoperative complications, including delayed union, nonunion (pseudarthrosis), and discomfort related to hardware. Percutaneous arthrodesis could be an interesting alternative and could offer reduced soft tissue trauma, faster recovery, and similar consolidation rates. This study presents a retrospective evaluation of the clinical and radiologic outcomes of percutaneous MTP1 arthrodesis using a single 4.5-mm cannulated screw fixation.
Methods:
Between December 2019 and December 2023, 31 feet (27 patients) underwent a standardized percutaneous technique, performed by a single surgeon. Operative indications were based on persistent pain resistant to conservative treatments for >6 months. The postoperative evaluation included pre- and postoperative weight-bearing radiographs (at 6 and 24 weeks, and at the final follow-up at an average of 24 months) and analysis of functional scores: visual analogue scale (VAS) for pain, European Foot & Ankle Society (EFAS), and Foot Function Index (FFI). The fixation angles were also measured and postoperative complications analyzed.
Results:
The fusion rate was 93.5% (29/31 feet). Postoperative pain significantly decreased, with a mean VAS score reduction of 4.8 points. Functional scores showed notable improvement with EFAS, from 7.3/24 to 15.7/24 (P < .0001), and FFI, from 46/100 to 11.7/100 (P < .0001). Complications included 2 asymptomatic nonunions and 4 hardware removals. No infection or nerve injury was observed.
Conclusion:
Percutaneous MTP1 arthrodesis with single screw fixation was found in this study to be an effective and reproducible technique, offering a high radiographic bone fusion rate while minimizing soft tissue damage. Our results demonstrate a significant improvement in functional scores, a notable reduction in pain, and high patient satisfaction. This percutaneous approach may represent a promising alternative to open surgery in select patients.
Level Of Evidence:
Level IV, therapeutic case series.
