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Initial MTPJ arthrodesis may increase angular correction based on hallux valgus deformity severity

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CHICAGO — Correction of the intermetatarsal angle increases after metatarsophalangeal joint arthrodesis based on the severity of hallux valgus deformity, according to data presented here.

“This contradicts previous literature, which says only a finite amount of correction can be achieved,” Raheel Shariff, MD, said during his presentation at the International Federation of Foot & Ankle Societies Triennial Meeting.

Raheel Shariff

Shariff and colleagues evaluated 89 patients who underwent a first metatarsophalangeal joint (MTPJ) arthrodesis fusion for primary or recurrent idiopathic hallux valgus between 2000 and 2010. Radiographs of all patients were reviewed before and after fusion using criteria on angular measurements from the American Orthopaedic Foot & Ankle Society ad hoc committee.

Thirty-five patients underwent previous hallux valgus corrective surgery. Mean follow-up was 8 years.

Patients had a 96% fusion rate, according to Shariff. Mild, moderate and severe deformity was present in 41, 30 and 18 patients, respectively, according to the intermetatarsal angle (IMA).

Mean IMA correction was higher in the initial hallux valgus surgery cohort compared with the prior failed surgery group (5.6° and 3.9°, respectively).

Mean improvement in postoperative IMA (4.9°) demonstrated a 34.5% decrease from preoperative findings, according to Shariff. Additionally, a progressive increase in mean IMA correction from mild to severe patient cohorts was observed.

The cohort fixed with cannulated screws exhibited lower mean postoperative proximal phalanx dorsiflexion angle than those fixed with any variety of plate, suggesting plate-based fixation would provide better fixation, according to Shariff. — by Christian Ingram

Reference: Shariff R. Radiographic results of first metatarsophalangeal joint arthrodesis for idiopathic and recurrent hallux valgus radiographic results of first metatarsophalangeal joint arthrodesis for idiopathic and recurrent hallux valgus. Presented at: International Federation of Foot & Ankle Societies Triennial Meeting; Sept. 19-21, 2014; Chicago.

Disclosure: Shariff has no relevant financial disclosures.