Molded arthrodesis of the hallux metatarsophalangeal joint using the crossed-screw technique: Surgical technique, results and functional outcomes

BackgroundWe describe the surgical technique, results and functional outcomes of molded arthrodesis of hallux metatarsophalangeal (MTP) joint using crossed-screw fixation.Methods23 Toes in 21 consecutive patients operated between September 2007 and January 2010 were included for the retrospective study. Average age was 60.0 years (range 31–84 years) with male female ratio being 3:4. Differential pitch cannulated crossed screw technique was used in all cases. At the latest follow-up, the radiological findings, the hallux-forefoot AOFAS scores and patient satisfaction questionnaires were used to assess outcomes.ResultsOverall fusion rate was 91% with a mean hallux valgus angle of 13.6° (range 8–22°) and a mean dorsi-flexion angle of 25° (range 18–30°). Complication rate was 13% that included two superficial wound infections and one failed fusion that underwent a successful fusion after revision surgery. At a mean follow-up of 17 months (range 6–34 months), the mean AOFAS score was 79 (out of a maximum of 90). 92% of the patients were satisfied with the final outcome and 83% mentioned that they would have the procedure again.ConclusionsCrossed-screw technique of arthrodesis of the first MTP joint is successful for relief of pain, allowing a high level of function and good patient satisfaction.