Minimally-invasive hallux arthrodesis with endomedullary and a crossed screw fixation

Foot Ankle Surg. 2020 Oct;26(7):744-749. doi: 10.1016/j.fas.2019.09.005. Epub 2019 Sep 28.

Abstract

Background: Minimally invasive surgery has several advantages: minor pain, smaller incisions and less tissue damage than traditional open surgery. Hallux arthrodesis with an endomedullary screw fixation provides compression and axial stability. The aim of this study was to describe the procedure and evaluate our first results of the minimally invasive first metatarsophalangeal arthrodesis with an endomedullary screw combined with a crossed screw fixation.

Methods: We retrospectively studied 15feet, with a minimum 1year follow-up. Patients were evaluated with full-load radiographs and AOFAS score preoperatively and at last follow-up.

Results: Consolidation rate was 93.3%, radiological consolidation time was 18 weeks (14-60). Radiographic alignment was achieved with satisfactory results. The preoperative AOFAS score improved from a mean 49 to 90 (p=0.001). There was one postoperative superficial site infection, which healed and a patient developed a pseudarthrosis but it was asymptomatic.

Conclusions: The minimally invasive metatarsophalangeal arthrodesis with an intramedullary screw is a secure procedure with comparable results to open techniques.

Level of clinical evidence: 4.

Keywords: Arthritis; Endomedullar screw; Hallux disorders; Hallux rigidus; Mini-Invasive; Percutaneous.

MeSH terms

  • Aged
  • Arthrodesis / methods*
  • Bone Screws*
  • Female
  • Hallux Rigidus / diagnosis
  • Hallux Rigidus / surgery*
  • Humans
  • Male
  • Metatarsophalangeal Joint / diagnostic imaging
  • Metatarsophalangeal Joint / surgery*
  • Minimally Invasive Surgical Procedures / methods*
  • Radiography
  • Retrospective Studies