Immediate Weightbearing Following First Metatarsal Phalangeal Joint Arthrodesis With 2 Nickel Titanium Alloy Staples

The use of staples has been shown to be a reasonable fixation technique to achieve stability of a first MTPJ arthrodesis. Although it has been shown to be a weaker construct than crossed screws or plate and screw combinations, their ease of insertion, low profile, and stability make them a desirable...

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Bibliographic Details
Published in:The Journal of foot and ankle surgery 2024-01, Vol.63 (1), p.42-46
Main Authors: Ravenell, Rahn A., Doh, Kwame
Format: Article
Language:English
Subjects:
Alloys
Arthrodesis - methods
bunion
first metatarsal phalangeal joint fusion
hallux rigidus
Hallux Rigidus - surgery
hallux valgus
Hallux Valgus - diagnostic imaging
Hallux Valgus - surgery
Humans
Metatarsal Bones - surgery
Metatarsophalangeal Joint - diagnostic imaging
Metatarsophalangeal Joint - surgery
Radiography
Retrospective Studies
staples
Weight-Bearing
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Summary:The use of staples has been shown to be a reasonable fixation technique to achieve stability of a first MTPJ arthrodesis. Although it has been shown to be a weaker construct than crossed screws or plate and screw combinations, their ease of insertion, low profile, and stability make them a desirable choice for first MTPJ arthrodesis fixation. However, because of this relative weakness, the question remains whether immediate weightbearing when using staples is advisable. The aim of this study is to determine whether the use of 2 nickel-titanium alloy (NITINOL) staples, placed at 90° to one another is a stable enough construct to support full, immediate weightbearing following first MTPJ arthrodesis. We performed a retrospective chart review of patients undergoing first MTPJ arthrodesis by a single surgeon utilizing 2 NITINOL staples placed at 90° to one another. Patients were allowed to be fully weightbearing immediately postoperatively. Forty-seven of 50 (94%) patients achieved complete radiologic consolidation of fusion at 12 weeks, with only 3 requiring revision surgery for nonunion. All of the patients requiring revision surgery for nonunion, had preoperative diagnosis of hallux abducto valgus. We concluded that the use of staples is a viable option for first MTPJ arthrodesis, and immediate weightbearing does not increase rate of nonunion or revision surgery when compared to other fixation techniques.
ISSN:1067-2516
1542-2224
DOI:10.1053/j.jfas.2023.08.009