Corrective Realignment Arthrodesis of the First Tarsometatarsal Joint Without Wedge Resection

Foot Ankle Spec. 2015 Aug;8(4):284-8. doi: 10.1177/1938640014560167. Epub 2014 Dec 3.

Abstract

Moderate to severe hallux valgus (HV) has traditionally been treated with a corrective osteotomy or a tarsometatarsal arthrodesis. Tarsometatarsal arthrodesis can be performed as a planar wedge resection or using a joint curettage technique. Little is known about whether adequate correction can be obtained with purely a joint curettage technique. The purpose of this study is to evaluate the corrective power of a first tarsometatarsal joint (TMTJ) arthrodesis using a nonplanar wedge curettage technique. A retrospective radiograph and chart review was performed on 99 consecutive patients (110 feet) who underwent a first TMTJ arthrodesis for primary HV correction utilizing a curettage technique. The radiographic measurements collected were the first intermetatarsal angle, HV angle, and tibial sesamoid position and were obtained at the following intervals: preoperative, immediate postoperative, and 6 months postoperative. In all, 91 patients (100 feet) qualified for statistical analysis. There was a significant decrease in all 3 measurements from the preoperative throughout the entire postoperative time period (P < .001). The authors demonstrate the ability to achieve significant angular correction with a joint curettage method for a tarsometatarsal arthrodesis.

Levels of evidence: Therapeutic, Level IV: Case series.

Keywords: Lapidus; intermetatarsal angle; planar resection; tarsometatarsal fusion.

MeSH terms

  • Arthrodesis / methods*
  • Bone Screws
  • Female
  • Hallux Valgus / surgery*
  • Humans
  • Male
  • Metatarsal Bones / surgery*
  • Metatarsophalangeal Joint / surgery*
  • Middle Aged
  • Osteotomy
  • Retrospective Studies
  • Treatment Outcome