Dual plating with bone block arthrodesis of the first metatarsophalangeal joint: A clinical retrospective review

- Patients undergoing an MTP fusion can be successfully treated with 90/90 plating with interpositional graft.
- The overall union rate was 90.9%, with an average restoration of 1.1 cm in length to the first ray.
- The average time to fusion was 10.7 ± 1 weeks.
- The mean preoperative AOFAS score improved significantly.

BackgroundFirst metatarsal phalangeal joint (MTP) arthrodesis is challenging in the setting of bone loss. The purpose of this study was to describe the results of interpositional grafting and arthrodesis of the first MTP joint using two plates in a 90/90 configuration.Materials and methodsEleven patients had an MTP arthrodesis with 90-90 plating with an interpositional allograft. We analyzed the fusion rate, restoration of first ray length, patient satisfaction, and complication rates.ResultsThe overall union rate was 90.9%, with an average restoration of 11 ± 4.5 mm in length to the first ray. The average time to fusion was 10.7 ± 1 weeks. The mean preoperative AOFAS score improved significantly. The complication rate was 18.2% and included one superficial wound infection and one non-union who underwent a successful fusion after revision.ConclusionArthrodesis of the first MTP joint with two 90/90 plates and restoration of length using an interpositional graft has excellent patient satisfaction and functional outcomes.