The first metatarsophalangeal joint arthrodesis is indicated for the treatment of various pathologies as a technique to reduce pain and improve the support of the first radius. Numerous surgical ...techniques and fixation methods have been described, with the combination of a dorsal plate and an interfragmentary screw being the one that has shown to be the most stable construct in biomechanical studies. Our aim is to analyze the radiological results after metatarsophalangeal arthrodesis of the hallux using a dorsal plate associated or not with an interfragmentary screw. The differences in terms of consolidation rates and complications in patients diagnosed with hallux rigidus, hallux valgus, hallux varus and failure of previous surgeries were evaluated.
A retrospective cohort study of 55 patients with a mean age of 65.10 years in whom a dorsal plate was used was performed. Patients were divided into two groups depending on whether or not an interfragmentary screw was used. The minimum follow-up was 6 months after surgery. The assessment of the pre and postoperative radiological results was based on the variation of the hallux angle, the intermetatarsal angle and the dorsal metatarsophalangeal angle of the hallux, as well as the cases of nonunion identified in each study group.
The radiological results, statistically significant differences (p<0.05) were only found in the dorsal metatarsophalangeal angle between both study groups. No statistically significant differences were found regarding the radiological evaluation of the pre and postoperative hallux angle and intermetatarsal angle. An equal decrease of each angles was observed in both study groups. Regarding the consolidation rate, statistically significant differences (p<0.05) were found between group A, which associated an interfragmentary screw, presenting a consolidation rate of 92%, and group B, which did not associate an interfragmentary screw, and that presented a union rate of 63%.
Hallux metatarsophalangeal arthrodesis of the hallux with a dorsal plate and interfragmentary screw show best results regarding consolidation rate and complications compared to those cases in which an interfragmentary screw was not used.
La artrodesis de la articulación metatarsofalángica (MTF) del hallux es una intervención quirúrgica indicada para el tratamiento de diversas afecciones, cuyo objetivo es aliviar el dolor y mejorar el apoyo del primer radio. Existen diversas técnicas quirúrgicas y métodos de fijación para llevar a cabo la artrodesis de dicha articulación, siendo la combinación de placa dorsal y tornillo interfragmentario la que ha demostrado en diversos estudios biomecánicos mayor estabilidad. Nuestro objetivo es analizar los resultados radiológicos tras artrodesis metatarsofalángica del hallux utilizando placa dorsal asociada o no a tornillo interfragmentario, valorando las diferencias en relación a la consolidación y complicaciones en pacientes diagnosticados de hallux rígidus, hallux valgus, hallux varus y fracaso de cirugías previas.
Realizamos un estudio de cohortes retrospectivo de 55 casos con una edad media de 65,10 años, intervenidos de una artrodesis de la articulación metatarsofalángica del hallux con placa dorsal, divididos en 2 grupos de estudio, según asocien o no a tornillo de compresión sin cabeza, con un seguimiento de al menos 6 meses postoperatorios. Valoramos los resultados radiológicos pre y postoperatorios basándose en la variación de los ángulos estudiados (ángulo del hallux, ángulo intermetatarsal y ángulo metatarsofalángico dorsal del primer dedo), así como los casos de seudoartrosis encontrados en cada grupo de estudio.
En cuanto a los resultados radiológicos, únicamente se encuentran diferencias estadísticamente significativas (p<0,05) en relación con el ángulo de dorsiflexión posquirúrgico entre ambos grupos de estudio. No se encontraron diferencias estadísticamente significativas en relación con el análisis radiológico del ángulo del hallux e intermetatarsal pre y posquirúrgico, ya que se observa que disminuyen igual en ambos grupos de estudio. El grupo A, que asocia tornillo interfragmentario, presentó una tasa de consolidación del 92%, frente al grupo B, sin tornillo a compresión, que fue del 63%, siendo estas diferencias estadísticamente significativas (p<0,05).
La artrodesis metatarsofalángica del hallux con placa dorsal asociada a tornillo interfragmentario obtiene mejores resultados en lo que se refiere a consolidación y complicaciones respecto a aquellos casos en los que no se utiliza el tornillo interfragmentario.
The first metatarsophalangeal joint arthrodesis is indicated for the treatment of various pathologies as a technique to reduce pain and improve the support of the first radius. Numerous surgical ...techniques and fixation methods have been described, with the combination of a dorsal plate and an interfragmentary screw being the one that has shown to be the most stable construct in biomechanical studies. Our aim is to analyze the radiological results after metatarsophalangeal arthrodesis of the hallux using a dorsal plate associated or not with an interfragmentary screw. The differences in terms of consolidation rates and complications in patients diagnosed with hallux rigidus, hallux valgus, hallux varus and failure of previous surgeries were evaluated.INTRODUCTION AND AIMSThe first metatarsophalangeal joint arthrodesis is indicated for the treatment of various pathologies as a technique to reduce pain and improve the support of the first radius. Numerous surgical techniques and fixation methods have been described, with the combination of a dorsal plate and an interfragmentary screw being the one that has shown to be the most stable construct in biomechanical studies. Our aim is to analyze the radiological results after metatarsophalangeal arthrodesis of the hallux using a dorsal plate associated or not with an interfragmentary screw. The differences in terms of consolidation rates and complications in patients diagnosed with hallux rigidus, hallux valgus, hallux varus and failure of previous surgeries were evaluated.A retrospective cohort study of 55 patients with a mean age of 65.10 years in whom a dorsal plate was used was performed. Patients were divided into 2 groups depending on whether or not an interfragmentary screw was used. The minimum follow-up was 6 months after surgery. The assessment of the pre and postoperative radiological results was based on the variation of the hallux angle, the intermetatarsal angle and the dorsal metatarsophalangeal angle of the hallux, as well as the cases of nonunion identified in each study group.MATERIAL AND METHODSA retrospective cohort study of 55 patients with a mean age of 65.10 years in whom a dorsal plate was used was performed. Patients were divided into 2 groups depending on whether or not an interfragmentary screw was used. The minimum follow-up was 6 months after surgery. The assessment of the pre and postoperative radiological results was based on the variation of the hallux angle, the intermetatarsal angle and the dorsal metatarsophalangeal angle of the hallux, as well as the cases of nonunion identified in each study group.The radiological results, statistically significant differences (p<0.05) were only found in the dorsal metatarsophalangeal angle between both study groups. No statistically significant differences were found regarding the radiological evaluation of the pre and postoperative hallux angle and intermetatarsal angle. An equal decrease of each angles was observed in both study groups. Regarding the consolidation rate, statistically significant differences (p<0.05) were found between group A, which associated an interfragmentary screw, presenting a consolidation rate of 92%, and group B, which did not associate an interfragmentary screw, and that presented a union rate of 63%.RESULTSThe radiological results, statistically significant differences (p<0.05) were only found in the dorsal metatarsophalangeal angle between both study groups. No statistically significant differences were found regarding the radiological evaluation of the pre and postoperative hallux angle and intermetatarsal angle. An equal decrease of each angles was observed in both study groups. Regarding the consolidation rate, statistically significant differences (p<0.05) were found between group A, which associated an interfragmentary screw, presenting a consolidation rate of 92%, and group B, which did not associate an interfragmentary screw, and that presented a union rate of 63%.Hallux metatarsophalangeal arthrodesis of the hallux with a dorsal plate and interfragmentary screw show best results regarding consolidation rate and complications compared to those cases in which an interfragmentary screw was not used.CONCLUSIONSHallux metatarsophalangeal arthrodesis of the hallux with a dorsal plate and interfragmentary screw show best results regarding consolidation rate and complications compared to those cases in which an interfragmentary screw was not used.
La artrodesis de la articulación metatarsofalángica del hallux es una intervención quirúrgica indicada para el tratamiento de diversas dolencias, cuyo objetivo es aliviar el dolor y mejorar el apoyo ...del primer radio. Existen diversas técnicas quirúrgicas y métodos de fijación para llevar a cabo la artrodesis de dicha articulación, siendo la combinación de placa dorsal y tornillo interfragmentario la que ha demostrado en diversos estudios biomecánicos mayor estabilidad. Nuestro objetivo es analizar los resultados radiológicos tras artrodesis metatarsofalángica del hallux utilizando placa dorsal asociada o no a tornillo interfragmentario, valorando las diferencias en relación con la consolidación y las complicaciones en pacientes diagnosticados de hallux rigidus, hallux valgus, hallux varus y fracaso de cirugías previas.
Realizamos un estudio de cohortes retrospectivo de 55 casos con una edad media de 65,10 años, intervenidos de una artrodesis de la articulación metatarsofalángica del hallux con placa dorsal, divididos en 2 grupos de estudio, según asocien o no tornillo de compresión sin cabeza, con un seguimiento de al menos 6 meses postoperatorios. Valoramos los resultados radiológicos pre y postoperatorios basándonos en la variación de los ángulos estudiados (ángulo del hallux, ángulo intermetatarsal y ángulo metatarsofalángico dorsal del primer dedo), así como los casos de seudoartrosis encontrados en cada grupo de estudio.
En cuanto a los resultados radiológicos, únicamente se encuentran diferencias estadísticamente significativas (p<0,05) en relación con el ángulo de dorsiflexión posquirúrgico entre ambos grupos de estudio. No se encontraron diferencias estadísticamente significativas en relación con el análisis radiológico del ángulo del hallux e intermetatarsal pre y posquirúrgico, ya que se observa que disminuyen igual en ambos grupos de estudio. El grupo A, que asocia tornillo interfragmentario, presentó una tasa de consolidación del 92%, frente al grupo B, sin tornillo a compresión, que fue del 63%, siendo estas diferencias estadísticamente significativas (p<0,05).
La artrodesis metatarsofalángica del hallux con placa dorsal asociada a tornillo interfragmentario obtiene mejores resultados en lo que se refiere a consolidación y complicaciones respecto a aquellos casos en los que no se utiliza el tornillo interfragmentario.
The first metatarsophalangeal joint arthrodesis is indicated for the treatment of various pathologies as a technique to reduce pain and improve the support of the first radius. Numerous surgical techniques and fixation methods have been described, with the combination of a dorsal plate and an interfragmentary screw being the one that has shown to be the most stable construct in biomechanical studies. Our aim is to analyze the radiological results after metatarsophalangeal arthrodesis of the hallux using a dorsal plate associated or not with an interfragmentary screw. The differences in terms of consolidation rates and complications in patients diagnosed with hallux rigidus, hallux valgus, hallux varus and failure of previous surgeries were evaluated.
A retrospective cohort study of 55 patients with a mean age of 65.10 years in whom a dorsal plate was used was performed. Patients were divided into 2 groups depending on whether or not an interfragmentary screw was used. The minimum follow-up was 6 months after surgery. The assessment of the pre and postoperative radiological results was based on the variation of the hallux angle, the intermetatarsal angle and the dorsal metatarsophalangeal angle of the hallux, as well as the cases of nonunion identified in each study group.
The radiological results, statistically significant differences (p<0.05) were only found in the dorsal metatarsophalangeal angle between both study groups. No statistically significant differences were found regarding the radiological evaluation of the pre and postoperative hallux angle and intermetatarsal angle. An equal decrease of each angles was observed in both study groups. Regarding the consolidation rate, statistically significant differences (p<0.05) were found between group A, which associated an interfragmentary screw, presenting a consolidation rate of 92%, and group B, which did not associate an interfragmentary screw, and that presented a union rate of 63%.
Hallux metatarsophalangeal arthrodesis of the hallux with a dorsal plate and interfragmentary screw show best results regarding consolidation rate and complications compared to those cases in which an interfragmentary screw was not used.
The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the ...clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies.
We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis).
The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement.
Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.
En el desarrollo del pie plano valgo adquirido del adulto ha cobrado gran importancia el fallo de la columna medial, y no tanto la rotura del tibial posterior, siendo principalmente la lesión del ligamento en hamaca calcaneonavicular (spring ligament) el determinante del desarrollo de esta deformidad. Nuestro objetivo es analizar los resultados clínico-radiológicos de la reparación del ligamento en hamaca, y valorar la utilidad e integración de las cuñas de titanio poroso en las osteotomías a las que se asocia la reparación ligamentosa.
Realizamos un estudio retrospectivo de 23 casos con una edad media de 63 años, diagnosticados de pie plano valgo adquirido del adulto estadio IIB de la clasificación RAM tras fallo de tratamiento ortoprotésico, valorando los resultados clínicos mediante la escala de la American Orthopaedic Foot and Ankle Society y los resultados radiológicos pre y postoperatorios basándose en la variación de los ángulos estudiados (cobertura talonavicular y ángulo talar-1.er metatarsiano en la proyección dorsoplantar y línea de Meary en la proyección lateral).
La puntuación media en escala de la American Orthopaedic Foot and Ankle Society pasó de 52±10 preoperatorio a 88±6 (p<0,05). En cuanto a los resultados radiológicos se demostró una mejoría estadísticamente significativa (p<0,05) en la variación de los ángulos en el postoperatorio.
La reparación de los estabilizadores mediales, asociada a técnicas óseas, ofrece excelentes resultados clínico-radiológicos en el tratamiento del pie plano valgo adquirido del adulto estadio IIB. Además, las cuñas de titanio poroso presentan una adecuada integración, evitando los problemas de pinzamiento de los peroneos, asociados al uso de placas y la necesidad posterior de retirada.
Insertional tendinopathy accounts for 23% of the pathology of the Achilles tendon. Surgery is indicated when conservative treatment of pain and functional limitation fails. Our objective is to ...analyse the clinical-functional results of surgical treatment with disinsertion, debridement and double row reattachment with high strength suture tape.
We present 13 patients with insertional Achilles tendinopathy, treated between February 2015 and October 2016. In all of them we performed inverted T-tendon disinsertion, debridement and calcareoplasty followed by double row tendon re-anchorage, without knots, with high resistance suture tape. Functional results were assessed with the AOFAS scale before and after surgery, with an average follow-up of 22 months.
The patients, 11 males and 2 females, with an average age of 43 years; presented a preoperative AOFAS score of 34.77±10.1 that reached 90.85±7 points after the operation, with an average increase of 56.08 points (IC95% 48.13–64.02 – p<0.01). The time to return to sports activities was 19 weeks (16–22). There were no complications.
The technique we present reports excellent results as a surgical treatment of insertional Achilles tendinopathy with intralesional calcification; it allows a wide contact surface between bone and tendon and an earlier return to previous sports activity.
La tendinopatía insercional supone el 23% de la patología del tendón de Aquiles. La cirugía está indicada cuando fracasa el tratamiento conservador del dolor y limitación funcional. Nuestro objetivo es analizar los resultados clínico-funcionales del tratamiento quirúrgico con desinserción, desbridamiento y reanclaje en doble hilera con cinta de sutura de alta resistencia.
Presentamos 13 pacientes con tendinopatía insercional de Aquiles, tratados intervenidos entre febrero de 2015 y octubre de 2016. En todos se realizó desinserción del tendón en T invertida, desbridamiento y calcaneoplastia seguido de reanclaje del tendón en doble hilera, sin nudos, con cinta de sutura de alta resistencia. Se valoraron los resultados funcionales con la escala AOFAS antes y después de la cirugía, con un seguimiento medio de 22 meses.
Los pacientes, 11 varones y 2 mujeres, con una edad media de 43 años; presentaban una puntuación AOFAS preoperatoria de 34,77±10,1 que alcanzó 90,85±7 puntos tras la intervención, con un incremento medio de 56,08 puntos (IC95% 48,13-64,02 – p<0,01). El tiempo hasta la reincorporación a actividades deportivas fue 19 semanas (16–22). No hubo ninguna complicación.
La técnica que presentamos reporta unos resultados excelentes como tratamiento quirúrgico de la tendinopatía insercional del Aquiles con calcificación intralesional; permite una amplia superficie de contacto entre hueso y tendón y una reincorporación más precoz a la actividad deportiva previa.
En el desarrollo del pie plano valgo adquirido del adulto ha cobrado gran importancia el fallo de la columna medial, y no tanto la rotura del tibial posterior, siendo principalmente la lesión del ...ligamento en hamaca calcaneonavicular (spring ligament) el determinante del desarrollo de esta deformidad.
Nuestro objetivo es analizar los resultados clínico-radiológicos de la reparación del ligamento en hamaca y valorar la utilidad e integración de las cuñas de titanio poroso en las osteotomías a las que se asocia la reparación ligamentosa.
Realizamos un estudio retrospectivo de 23 casos con una edad media de 63 años, diagnosticados de pie plano valgo adquirido del adulto estadio IIB de la clasificación RAM tras fallo de tratamiento ortoprotésico, valorando los resultados clínicos mediante la escala de la American Orthopaedic Foot and Ankle Society y los resultados radiológicos pre- y postoperatorios basándose en la variación de los ángulos estudiados (cobertura talonavicular y ángulo talar - 1.° metatarsiano en la proyección dorsoplantar y línea de Meary en la proyección lateral).
Los puntuación media en escala de la American Orthopaedic Foot and Ankle Society pasó de 52±10 preoperatorio a 88±6 (p<0,05). En cuanto a los resultados radiológicos, se demostró una mejoría estadísticamente significativa (p<0,05) en la variación de los ángulos en el postoperatorio.
La reparación de los estabilizadores mediales, asociada a técnicas óseas ofrece excelentes resultados clínico-radiológicos en el tratamiento del pie plano valgo adquirido del adulto estadio IIB.
Además, las cuñas de titanio poroso presentan una adecuada integración, evitando los problemas de pinzamiento de los peroneos asociada al uso de placas y la necesidad posterior de retirada.
The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies.
We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis).
The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement.
Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.
La tendinopatía insercional supone el 23% de las dolencias del tendón de Aquiles. La cirugía está indicada cuando fracasa el tratamiento conservador del dolor y limitación funcional. Nuestro objetivo ...es analizar los resultados clínico-funcionales del tratamiento quirúrgico con desinserción, desbridamiento y reanclaje en doble hilera con cinta de sutura de alta resistencia.
Presentamos 13 pacientes con tendinopatía insercional de Aquiles, intervenidos entre febrero de 2015 y octubre de 2016. En todos se realizó desinserción del tendón en T invertida, desbridamiento y calcaneoplastia con posterior reanclaje del tendón en doble hilera, sin nudos, con cinta de sutura de alta resistencia. Se valoraron los resultados funcionales con la escala AOFAS antes y después de la cirugía, con un seguimiento medio de 22 meses.
Los pacientes, 11 varones y 2 mujeres, con una edad media de 43 años, presentaban una puntuación AOFAS preoperatoria de 34,77±10,1 que alcanzó 90,85±7 puntos tras la intervención, con un incremento medio de 56,08 puntos (IC 95% 48,13-64,02; p<0,01). El tiempo hasta la reincorporación a actividades deportivas fue 19 semanas (16-22). No hubo ninguna complicación.
La técnica que presentamos reporta unos resultados excelentes como tratamiento quirúrgico de la tendinopatía insercional del Aquiles con calcificación intralesional, permite una amplia superficie de contacto entre hueso y tendón y una reincorporación más precoz a la actividad deportiva previa.
Insertional tendinopathy accounts for 23% of the pathology of the Achilles tendon. Surgery is indicated when conservative treatment of pain and functional limitation fails. Our objective is to analyse the clinical-functional results of surgical treatment with disinsertion, debridement and double row reattachment with high strength suture tape.
We present 13 patients with insertional Achilles tendinopathy, treated between February 2015 and October 2016. In all of them we performed inverted T-tendon disinsertion, debridement and calcareoplasty followed by double row tendon re-anchorage, without knots, with high resistance suture tape. Functional results were assessed with the AOFAS scale before and after surgery, with an average follow-up of 22 months.
The patients, 11 males and 2 females, with an average age of 43 years, presented a preoperative AOFAS score of 34.77±10.1 that reached 90.85±7 points after the operation, with an average increase of 56.08 points (IC 95% 48.13-64.02; P<0.01). The time to return to sports activities was 19 weeks (16-22). There were no complications.
The technique we present reports excellent results as a surgical treatment of insertional Achilles tendinopathy with intralesional calcification; it allows a wide contact surface between bone and tendon and an earlier return to previous sports activity.
The first metatarsophalangeal joint arthrodesis is indicated for the treatment of various pathologies as a technique to reduce pain and improve the support of the first radius. Numerous surgical ...techniques and fixation methods have been described, with the combination of a dorsal plate and an interfragmentary screw being the one that has shown to be the most stable construct in biomechanical studies. Our aim is to analyze the radiological results after metatarsophalangeal arthrodesis of the hallux using a dorsal plate associated or not with an interfragmentary screw. The differences in terms of consolidation rates and complications in patients diagnosed with hallux rigidus, hallux valgus, hallux varus and failure of previous surgeries were evaluated.BACKGROUND AND AIMSThe first metatarsophalangeal joint arthrodesis is indicated for the treatment of various pathologies as a technique to reduce pain and improve the support of the first radius. Numerous surgical techniques and fixation methods have been described, with the combination of a dorsal plate and an interfragmentary screw being the one that has shown to be the most stable construct in biomechanical studies. Our aim is to analyze the radiological results after metatarsophalangeal arthrodesis of the hallux using a dorsal plate associated or not with an interfragmentary screw. The differences in terms of consolidation rates and complications in patients diagnosed with hallux rigidus, hallux valgus, hallux varus and failure of previous surgeries were evaluated.A retrospective cohort study of 55 patients with a mean age of 65.10 years in whom a dorsal plate was used was performed. Patients were divided into two groups depending on whether or not an interfragmentary screw was used. The minimum follow-up was 6 months after surgery. The assessment of the pre and postoperative radiological results was based on the variation of the hallux angle, the intermetatarsal angle and the dorsal metatarsophalangeal angle of the hallux, as well as the cases of nonunion identified in each study group.MATERIALS AND METHODSA retrospective cohort study of 55 patients with a mean age of 65.10 years in whom a dorsal plate was used was performed. Patients were divided into two groups depending on whether or not an interfragmentary screw was used. The minimum follow-up was 6 months after surgery. The assessment of the pre and postoperative radiological results was based on the variation of the hallux angle, the intermetatarsal angle and the dorsal metatarsophalangeal angle of the hallux, as well as the cases of nonunion identified in each study group.The radiological results, statistically significant differences (p<0.05) were only found in the dorsal metatarsophalangeal angle between both study groups. No statistically significant differences were found regarding the radiological evaluation of the pre and postoperative hallux angle and intermetatarsal angle. An equal decrease of each angles was observed in both study groups. Regarding the consolidation rate, statistically significant differences (p<0.05) were found between group A, which associated an interfragmentary screw, presenting a consolidation rate of 92%, and group B, which did not associate an interfragmentary screw, and that presented a union rate of 63%.RESULTSThe radiological results, statistically significant differences (p<0.05) were only found in the dorsal metatarsophalangeal angle between both study groups. No statistically significant differences were found regarding the radiological evaluation of the pre and postoperative hallux angle and intermetatarsal angle. An equal decrease of each angles was observed in both study groups. Regarding the consolidation rate, statistically significant differences (p<0.05) were found between group A, which associated an interfragmentary screw, presenting a consolidation rate of 92%, and group B, which did not associate an interfragmentary screw, and that presented a union rate of 63%.Hallux metatarsophalangeal arthrodesis of the hallux with a dorsal plate and interfragmentary screw show best results regarding consolidation rate and complications compared to those cases in which an interfragmentary screw was not used.CONCLUSIONHallux metatarsophalangeal arthrodesis of the hallux with a dorsal plate and interfragmentary screw show best results regarding consolidation rate and complications compared to those cases in which an interfragmentary screw was not used.
The first metatarsophalangeal joint arthrodesis is indicated for the treatment of various pathologies as a technique to reduce pain and improve the support of the first radius. Numerous surgical ...techniques and fixation methods have been described, with the combination of a dorsal plate and an interfragmentary screw being the one that has shown to be the most stable construct in biomechanical studies. Our aim is to analyze the radiological results after metatarsophalangeal arthrodesis of the hallux using a dorsal plate associated or not with an interfragmentary screw. The differences in terms of consolidation rates and complications in patients diagnosed with hallux rigidus, hallux valgus, hallux varus and failure of previous surgeries were evaluated.
A retrospective cohort study of 55 patients with a mean age of 65.10 years in whom a dorsal plate was used was performed. Patients were divided into 2 groups depending on whether or not an interfragmentary screw was used. The minimum follow-up was 6 months after surgery. The assessment of the pre and postoperative radiological results was based on the variation of the hallux angle, the intermetatarsal angle and the dorsal metatarsophalangeal angle of the hallux, as well as the cases of nonunion identified in each study group.
The radiological results, statistically significant differences (p<0.05) were only found in the dorsal metatarsophalangeal angle between both study groups. No statistically significant differences were found regarding the radiological evaluation of the pre and postoperative hallux angle and intermetatarsal angle. An equal decrease of each angles was observed in both study groups. Regarding the consolidation rate, statistically significant differences (p<0.05) were found between group A, which associated an interfragmentary screw, presenting a consolidation rate of 92%, and group B, which did not associate an interfragmentary screw, and that presented a union rate of 63%.
Hallux metatarsophalangeal arthrodesis of the hallux with a dorsal plate and interfragmentary screw show best results regarding consolidation rate and complications compared to those cases in which an interfragmentary screw was not used.
The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the ...clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies.
We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis).
The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement.
Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.
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