Evaluation of different shape-memory staple configurations against crossed screws for first metatarsophalangeal joint arthrodesis: A biomechanical study

N, respectively. Paired 0-90° staples failed at 43 N ± 9 N, significantly lower than the 45-135° staples (141 N ± 25 N; p < 0.001) and crossed screws (180 N ± 67 N; p < 0.001). There was no significant difference between the 45-135° staples and crossed screws. Screws failed by sudden cortical fracture; staples displayed gradual pull‐out and shearing. First MTPJ arthrodeses fixed with single staples are not recommended. Arthrodeses fixed with staples at 0-90° to the sagittal plane were significantly less strong than two crossed screws. However, positioning oblique staples at 45-135° significantly improved stability, creating a construct as strong as, crossed screws. None of the constructs was strong enough for immediate weight bearing.