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Comparison of plate and compression screw in the treatment of hallux rigidus with arthrodesis: a retrospective study

Year 2024, Volume: 10 Issue: 6, 609 - 616, 04.11.2024
https://doi.org/10.18621/eurj.1457903

Abstract

Objectives: Although numerous surgical techniques and fixation methods have been described for the treatment of hallux rigidus (HR) with arthrodesis, consensus on the gold standard treatment has not been reached. The aim of this study is to retrospectively compare the clinical and radiological outcomes of compression screw fixation and plate fixation in the treatment of HR with arthrodesis.

Methods: Patients who underwent arthrodesis surgery due to HR between January 2021 and December 2023 at a single center were retrospectively reviewed. Patients who met the inclusion criteria were divided into two groups: those who underwent arthrodesis with plate fixation (PLATE) and those who underwent arthrodesis with compression screw fixation (SCREW). Demographic data including age, gender, affected side, operative time, hallux valgus angle (HVA), dorsiflexion angle, AOFAS scores, and implant irritation data were compared among patients with at least 3 months of follow-up.

Results: It was observed that all patients included in the study had successful bone union without any complications. There were no significant differences between the two groups in terms of age, gender, affected side, preoperative HVA, and preoperative AOFAS scores (P=0.970, P=0.426, P=0.694, P=0.216, and P=0.905, respectively). The mean operation time and postoperative AOFAS score were lower in the PLATE group compared to the SCREW group (P=0.006 and P=0.004, respectively). However, in the SCREW group, the dorsiflexion angle and the rate of implant irritation were lower compared to the PLATE group (P=0.016 and P=0.01, respectively).

Conclusions: In the surgical treatment of HR, both plate fixation arthrodesis and compression screw arthrodesis are reliable surgical techniques. While plate fixation arthrodesis is a faster and more practical method, arthrodesis with a compression screw results in fewer complaints related to the implant and provides a more functional recovery.

References

  • 1. Hamid KS, Parekh SG. Clinical Presentation and Management of Hallux Rigidus. Foot Ankle Clin. 2015;20(3):391-399. doi: 10.1016/j.fcl.2015.04.002.
  • 2. Ho B, Baumhauer J. Hallux rigidus. EFORT Open Rev. 2017;2(1):13-20. doi: 10.1302/2058-5241.2.160031.
  • 3. Yee G, Lau J. Current concepts review: hallux rigidus. Foot Ankle Int. 2008;29(6):637-646. doi: 10.3113/FAI.2008.0637.
  • 4. Gibson JN, Thomson CE. Arthrodesis or total replacement arthroplasty for hallux rigidus: a randomized controlled trial. Foot Ankle Int. 2005;26(9):680-690. doi: 10.1177/107110070502600904.
  • 5. Stevens J, de Bot RTAL, Hermus JPS, van Rhijn LW, Witlox AM. Clinical Outcome Following Total Joint Replacement and Arthrodesis for Hallux Rigidus: A Systematic Review. JBJS Rev. 2017;5(11):e2. doi: 10.2106/JBJS.RVW.17.00032.
  • 6. Stone OD, Ray R, Thomson CE, Gibson JN. Long-Term Follow-up of Arthrodesis vs Total Joint Arthroplasty for Hallux Rigidus. Foot Ankle Int. 2017;38(4):375-380. doi: 10.1177/1071100716682994.
  • 7. Fuhrmann RA. First metatarsophalangeal arthrodesis for hallux rigidus. Foot Ankle Clin. 2011;16(1):1-12. doi: 10.1016/j.fcl.2010.12.003.
  • 8. Lombardi CM, Silhanek AD, Connolly FG, Dennis LN, Keslonsky AJ. First metatarsophalangeal arthrodesis for treatment of hallux rigidus: a retrospective study. J Foot Ankle Surg. 2001;40(3):137-143. doi: 10.1016/s1067-2516(01)80079-x.
  • 9. Aas M, Johnsen TM, Finsen V. Arthrodesis of the first metatarsophalangeal joint for hallux rigidus--optimal position of fusion. Foot (Edinb). 2008;18(3):131-135. doi: 10.1016/j.foot.2008.03.002.
  • 10. Faraj AA, Naraen A, Twigg P. A comparative study of wire fixation and screw fixation in arthrodesis for the correction of hallux rigidus using an in vitro biomechanical model. Foot Ankle Int. 200;28(1):89-91. doi: 10.3113/FAI.2007.0016.
  • 11. Kang YS, Bridgen A. First metatarsophalangeal joint arthrodesis/fusion: a systematic review of modern fixation techniques. J Foot Ankle Res. 2022;15(1):30. doi: 10.1186/s13047-022-00540-9.
  • 12. Schafer KA, Baldini T, Hamati M, Backus JD, Hunt KJ, McCormick JJ. Two Orthogonal Nitinol Staples and Combined Nitinol Staple-Screw Constructs for a First Metatarsophalangeal Joint Arthrodesis: A Biomechanical Cadaver Study. Foot Ankle Int. 2022;43(11):1493-1500. doi: 10.1177/10711007221119157.
  • 13. Shah K, Augustine A, Carter R, McFadyen A. Arthrodesis of the first metatarsophalangeal joint: comparison of three techniques. J Am Podiatr Med Assoc. 2012;102(1):13-17. doi: 10.7547/1020013.
  • 14. Chien C, Alfred T, Freihaut R, Pit S. First Metatarsophalangeal Joint Arthrodesis in Hallux Valgus Versus Hallux Rigidus Using Cup and Cone Preparation Compression Screw and Dorsal Plate Fixation. Cureus. 2017;9(10):e1786. doi: 10.7759/cureus.1786.
  • 15. Coughlin MJ, Shurnas PS. Hallux rigidus: demographics, etiology, and radiographic assessment. Foot Ankle Int. 2003;24(10):731-743. doi: 10.1177/107110070302401002.
  • 16. Neri T, Beach AB, Farizon F, Philippot RJ. Advantages of a compression screw for the arthrodesis of the first metatarsophalangeal joint of the foot: comparative study.Acta Orthop Belg. 2020;86(Suppl 2):144-151.
  • 17. Coughlin MJ, Abdo RV. Arthrodesis of the first metatarsophalangeal joint with Vitallium plate fixation. Foot Ankle Int. 1994;15(1):18-28. doi: 10.1177/107110079401500105.
  • 18. Flavin R, Stephens MM. Arthrodesis of the first metatarsophalangeal joint using a dorsal titanium contoured plate. Foot Ankle Int. 2004;25(11):783-787. doi: 10.1177/107110070402501105.
  • 19. Goucher NR, Coughlin MJ. Hallux metatarsophalangeal joint arthrodesis using dome-shaped reamers and dorsal plate fixation: a prospective study. Foot Ankle Int. 2006;27(11):869-876. doi: 10.1177/107110070602701101.
  • 20. Besse JL, Chouteau J, Laptoiu D. Arthrodesis of the first metatarsophalangeal joint with ball and cup reamers and osteosynthesis with pure titanium staples Radiological evaluation of a continuous series of 54 cases. Foot Ankle Surg. 2010;16(1):32-37. doi: 10.1016/j.fas.2009.03.008.
  • 21. Roukis TS, Meusnier T, Augoyard M. Nonunion rate of first metatarsal-phalangeal joint arthrodesis with crossed titanium flexible intramedullary nails and a dorsal static staple with immediate weightbearing. J Foot Ankle Surg. 2012;51(2):191-194. doi: 10.1053/j.jfas.2011.10.041.
  • 22. Curtis MJ, Myerson M, Jinnah RH, Cox QG, Alexander I. Arthrodesis of the first metatarsophalangeal joint: a biomechanical study of internal fixation techniques. Foot Ankle. 1993;14(7):395-359. doi: 10.1177/107110079301400705.
  • 23. Politi J, John H, Njus G, Bennett GL, Kay DB. First metatarsal-phalangeal joint arthrodesis: a biomechanical assessment of stability. Foot Ankle Int. 2003;24(4):332-337. doi: 10.1177/107110070302400405.
  • 24. Pydah SK, Toh EM, Sirikonda SP, Walker CR. Intermetatarsal angular change following fusion of the first metatarsophalangeal joint. Foot Ankle Int. 2009;30(5):415-418. doi: 10.3113/FAI-2009-0415.
  • 25. García-Jarabo E, Alonso-Tejero D, Ramos-Ramos LM, Hernanz-González Y, Vilá Y Rico J. Better results in consolidation of hallux metatarsophalangeal arthrodesis with dorsal plate and interfragmentary compression screw. Rev Esp Cir Ortop Traumatol. 2024:S1888-4415(24)00057-2. doi: 10.1016/j.recot.2024.01.030.
Year 2024, Volume: 10 Issue: 6, 609 - 616, 04.11.2024
https://doi.org/10.18621/eurj.1457903

Abstract

References

  • 1. Hamid KS, Parekh SG. Clinical Presentation and Management of Hallux Rigidus. Foot Ankle Clin. 2015;20(3):391-399. doi: 10.1016/j.fcl.2015.04.002.
  • 2. Ho B, Baumhauer J. Hallux rigidus. EFORT Open Rev. 2017;2(1):13-20. doi: 10.1302/2058-5241.2.160031.
  • 3. Yee G, Lau J. Current concepts review: hallux rigidus. Foot Ankle Int. 2008;29(6):637-646. doi: 10.3113/FAI.2008.0637.
  • 4. Gibson JN, Thomson CE. Arthrodesis or total replacement arthroplasty for hallux rigidus: a randomized controlled trial. Foot Ankle Int. 2005;26(9):680-690. doi: 10.1177/107110070502600904.
  • 5. Stevens J, de Bot RTAL, Hermus JPS, van Rhijn LW, Witlox AM. Clinical Outcome Following Total Joint Replacement and Arthrodesis for Hallux Rigidus: A Systematic Review. JBJS Rev. 2017;5(11):e2. doi: 10.2106/JBJS.RVW.17.00032.
  • 6. Stone OD, Ray R, Thomson CE, Gibson JN. Long-Term Follow-up of Arthrodesis vs Total Joint Arthroplasty for Hallux Rigidus. Foot Ankle Int. 2017;38(4):375-380. doi: 10.1177/1071100716682994.
  • 7. Fuhrmann RA. First metatarsophalangeal arthrodesis for hallux rigidus. Foot Ankle Clin. 2011;16(1):1-12. doi: 10.1016/j.fcl.2010.12.003.
  • 8. Lombardi CM, Silhanek AD, Connolly FG, Dennis LN, Keslonsky AJ. First metatarsophalangeal arthrodesis for treatment of hallux rigidus: a retrospective study. J Foot Ankle Surg. 2001;40(3):137-143. doi: 10.1016/s1067-2516(01)80079-x.
  • 9. Aas M, Johnsen TM, Finsen V. Arthrodesis of the first metatarsophalangeal joint for hallux rigidus--optimal position of fusion. Foot (Edinb). 2008;18(3):131-135. doi: 10.1016/j.foot.2008.03.002.
  • 10. Faraj AA, Naraen A, Twigg P. A comparative study of wire fixation and screw fixation in arthrodesis for the correction of hallux rigidus using an in vitro biomechanical model. Foot Ankle Int. 200;28(1):89-91. doi: 10.3113/FAI.2007.0016.
  • 11. Kang YS, Bridgen A. First metatarsophalangeal joint arthrodesis/fusion: a systematic review of modern fixation techniques. J Foot Ankle Res. 2022;15(1):30. doi: 10.1186/s13047-022-00540-9.
  • 12. Schafer KA, Baldini T, Hamati M, Backus JD, Hunt KJ, McCormick JJ. Two Orthogonal Nitinol Staples and Combined Nitinol Staple-Screw Constructs for a First Metatarsophalangeal Joint Arthrodesis: A Biomechanical Cadaver Study. Foot Ankle Int. 2022;43(11):1493-1500. doi: 10.1177/10711007221119157.
  • 13. Shah K, Augustine A, Carter R, McFadyen A. Arthrodesis of the first metatarsophalangeal joint: comparison of three techniques. J Am Podiatr Med Assoc. 2012;102(1):13-17. doi: 10.7547/1020013.
  • 14. Chien C, Alfred T, Freihaut R, Pit S. First Metatarsophalangeal Joint Arthrodesis in Hallux Valgus Versus Hallux Rigidus Using Cup and Cone Preparation Compression Screw and Dorsal Plate Fixation. Cureus. 2017;9(10):e1786. doi: 10.7759/cureus.1786.
  • 15. Coughlin MJ, Shurnas PS. Hallux rigidus: demographics, etiology, and radiographic assessment. Foot Ankle Int. 2003;24(10):731-743. doi: 10.1177/107110070302401002.
  • 16. Neri T, Beach AB, Farizon F, Philippot RJ. Advantages of a compression screw for the arthrodesis of the first metatarsophalangeal joint of the foot: comparative study.Acta Orthop Belg. 2020;86(Suppl 2):144-151.
  • 17. Coughlin MJ, Abdo RV. Arthrodesis of the first metatarsophalangeal joint with Vitallium plate fixation. Foot Ankle Int. 1994;15(1):18-28. doi: 10.1177/107110079401500105.
  • 18. Flavin R, Stephens MM. Arthrodesis of the first metatarsophalangeal joint using a dorsal titanium contoured plate. Foot Ankle Int. 2004;25(11):783-787. doi: 10.1177/107110070402501105.
  • 19. Goucher NR, Coughlin MJ. Hallux metatarsophalangeal joint arthrodesis using dome-shaped reamers and dorsal plate fixation: a prospective study. Foot Ankle Int. 2006;27(11):869-876. doi: 10.1177/107110070602701101.
  • 20. Besse JL, Chouteau J, Laptoiu D. Arthrodesis of the first metatarsophalangeal joint with ball and cup reamers and osteosynthesis with pure titanium staples Radiological evaluation of a continuous series of 54 cases. Foot Ankle Surg. 2010;16(1):32-37. doi: 10.1016/j.fas.2009.03.008.
  • 21. Roukis TS, Meusnier T, Augoyard M. Nonunion rate of first metatarsal-phalangeal joint arthrodesis with crossed titanium flexible intramedullary nails and a dorsal static staple with immediate weightbearing. J Foot Ankle Surg. 2012;51(2):191-194. doi: 10.1053/j.jfas.2011.10.041.
  • 22. Curtis MJ, Myerson M, Jinnah RH, Cox QG, Alexander I. Arthrodesis of the first metatarsophalangeal joint: a biomechanical study of internal fixation techniques. Foot Ankle. 1993;14(7):395-359. doi: 10.1177/107110079301400705.
  • 23. Politi J, John H, Njus G, Bennett GL, Kay DB. First metatarsal-phalangeal joint arthrodesis: a biomechanical assessment of stability. Foot Ankle Int. 2003;24(4):332-337. doi: 10.1177/107110070302400405.
  • 24. Pydah SK, Toh EM, Sirikonda SP, Walker CR. Intermetatarsal angular change following fusion of the first metatarsophalangeal joint. Foot Ankle Int. 2009;30(5):415-418. doi: 10.3113/FAI-2009-0415.
  • 25. García-Jarabo E, Alonso-Tejero D, Ramos-Ramos LM, Hernanz-González Y, Vilá Y Rico J. Better results in consolidation of hallux metatarsophalangeal arthrodesis with dorsal plate and interfragmentary compression screw. Rev Esp Cir Ortop Traumatol. 2024:S1888-4415(24)00057-2. doi: 10.1016/j.recot.2024.01.030.
There are 25 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Original Articles
Authors

Ahmet Yurteri 0000-0001-5242-0275

Numan Mercan 0000-0002-0581-7023

Ahmet Yıldırım 0000-0002-3953-091X

Early Pub Date May 30, 2024
Publication Date November 4, 2024
Submission Date March 25, 2024
Acceptance Date May 5, 2024
Published in Issue Year 2024 Volume: 10 Issue: 6

Cite

AMA Yurteri A, Mercan N, Yıldırım A. Comparison of plate and compression screw in the treatment of hallux rigidus with arthrodesis: a retrospective study. Eur Res J. November 2024;10(6):609-616. doi:10.18621/eurj.1457903

e-ISSN: 2149-3189 


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