Arthrodesis of the first metatarsophalangeal joint using an intraosseous fixation device


first metatarsophalangeal joint arthrodesis; MTP1 arthrodesis; IOFIX; intraosseous fixation device

Published online: May 03 2022

Hannes E. Tytgat, Sander Wuite, Giovanni A. Matricali

From the UZ Leuven, Department of Orthopedics, Leuven, Belgium


The complication rate for an arthrodesis of the first metatarsophalangeal joint remains high. To improve results, we used a complete intraosseous fixation device (IOFIX) with proposed biomechanical advantages. Our hypothesis is that this technique has at least an equal union rate and less hardware irritation compared to other techniques. Seventy procedures were performed in 55 patients. Average follow-up was 24.5 months. All patients returned to follow-up after 6 weeks and were evaluated for union. Fifty-nine feet (84%) completed full follow- up. Union occurred in 62 of 70 feet (88.5%). Eight feet had nonunion at 1 year follow-up. Average time to fusion was 51 days. Three of 59 feet had malunion. No hardware removal was necessary. In conclusion, an MTP1 arthrodesis using IOFIX provides consistent and good functional outcomes. Due to the low-profile design, no hardware removal was necessary. However, union rates seem slightly lower compared to other techniques.