Retrospective study of the first metatarsophalangeal joint arthrodesist : about 39 cases

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Published Sep 30, 2010
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Vol. 88 No. 10 (2010): Issue Oct 2010

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Mondher Mestiri
Mohamed Bouabdellah
Abdelaziz Zarrouk
Skander Kammoun
Slah Baccari
Mondher Kooli
Mongi Zlitni

Abstract

Background : The first metatarsophalangeal joint arthrodesis is a fusion with optimal alignment of the first metatarsal and first phalanx wich conferring indolence, strength and stability
Aim: The goal of this study was to evaluate the place of arthrodesis of the first metatarso-phalangeal joint in surgery of the fore foot .
Methods: This work is based on analysis of records of 35 patients between 1995 and 2006. 39 first metatarsophalangeal joint arthrodesis were practice (3 were bilateral). They had a follow up of from three to ten years. All patients were called for a complete exploration radiographic and clinical evaluation according to the
criteria of KITAOKA. The average age of patients was 54 years.
Results: They were 28 women and 7 men. The indications were hallux rigidus in 51% cases and rheumatoid arthritis in 41% cases. The procedure used mostly a stable fixation with a compressive screw. The dorsal flexion recommended is between 20 and 30 °. Ankylosis of the ankle or the inter-phalangeal joint was an againstindication for the first metatarsophalangeal joint arthrodesis.
The study found a patient subjective satisfaction rate of 92 per cent, there was no pain for 89 per cent of cases. It was noted 4 non-fusion cases paradoxically with satisfactory functional result. There was no pain of inter-phalangeal joint in all cases when X-rays showed arthritis in 4 cases.
Conclusion: The first metatarsophalangeal joint arthrodesis, provided we respect a few simple principles, restores painless and satisfying function of foot.

Keywords:

Rheumatoid arthritis, Arthrodesis, hallux rigidus, Hallux valgus, Metatarsophalangeal

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