Arthrodesis of the First Metatarsophalangeal Joint Using a Single Screw: Retrospective Analysis of 109 Feet

Arthrodesis of the first metatarsophalangeal joint is a recommended technique for hallux rigidus. The preparation of the joint surfaces and the way in which fixation is achieved might be relevant in success or failure of the arthrodesis. All patients were selected from archived records of operations performed at the ‘Groene Hart’ Hospital in Gouda, the Netherlands, from 1996 until 2005. Patients were operated following a fixed protocol using flat surfaces and a single compression screw bridging the arthrodesis from proximal medial to distal lateral. Their charts were reviewed retrospectively. Answers to questions regarding their current pain, shoe wear, and walking ability were recorded using the criteria of the AOFAS foot score as a template in a questionnaire. Of a total of 109 arthrodesis, 104 (95.4 %) united within 8 weeks without problems. Four feet were re-operated for pseudoarthrosis and one was re-operated for malunion with too much dorsiflexion. Removal of the intramedullary screw was necessary in 85 feet (78%). Of the 79 patients who returned their questionnaire, 58 patients (73.4%) considered their problems solved and 57 patients (72%) were completely satisfied with the result. Our study shows that a single screw fixation method is an effective technique in treating hallux rigidus, with high satisfaction in patients between 40 and 80 years of age. Level of Clinical Evidence: 4

Key Words: fusion, hallux rigidus