Advantages of a compression screw for the arthrodesis of the first metatarsophalangeal joint of the foot : comparative study

Keywords:

Arthrodesis ; fibrous fusion ; non-union ; compression screw


Published online: Feb 09 2021

Thomas Neri, Aaron Beach Beach, Frederic Farizon, Remi Philippot

From the Department of Orthopedic Surgery, University Hospital of Saint-Etienne, France

Abstract

The purpose was to determine whether or not an additional compression screw to an arthrodesis of the first metatarsophalangeal joint (MTP1) by plate conferred any clinical and radiological benefits for the patient.

One hundred and five cases (95 patients) were prospectively enrolled and analysed in two groups : PLATE-only with 2 small plates fixation (n=51) and PLATE+compSCREW with an additional compression screw fixation (n=54). Both  groups were followed up over 4-years and were compared using the AOFAS score and a radiologic assessment to determine the fusion rate.

PLATE-only reported 6 failures : 2 cases of clinical mobilisation of the joint and 4 cases of painless fibrous fusion. In the PLATE+compSCREW group, there were 3 cases of painless fibrous fusion. When considering the fusion rate, there was a significant statistical difference between the two groups.

The use of an additional compression screw reduced the time to joint fusion and decreased the failure rate at last follow-up.

Study design : Prospective comparative cohort study.