A Short-Term Retrospective of First Metatarsophalangeal Joint Arthrodesis Using a Plate With PocketLock Fixation

Foot Ankle Spec. 2015 Dec;8(6):466-71. doi: 10.1177/1938640015585968. Epub 2015 May 8.


Background: Various techniques have been described for arthrodesis of the first metatarsophalangeal (MTP) joint. The purpose of this study was to retrospectively review the results of fixation for the first MTP arthrodesis of patients treated using dome-shaped reamers to prepare the joint surfaces and a novel MTP Plate with PocketLock fixation.

Methods: Between July 2012 and November 2013, 16 feet in 16 patients were treated with a first MTP arthrodesis with a MTP Plate with PocketLock fixation. The mean patient age was 58.8 years (range, 46-82 years). Physical and radiographic examinations were performed at follow-up visits. The average follow-up period was 17.3 months. The radiographs were examined for union (3 bridging cortices), time to union, hardware failure, or other radiographic complications. The charts were reviewed to assess AOFAS-MTP-IP (American Orthopaedic Foot & Ankle Society metatarsophalangeal-interphalangeal) scores and postoperative complications.

Results: Fusion was seen in 11 of 16 feet (68.8%) and partial union in 1 patient (6.3%). Five nonunions (31.2%) were noted in the sample group: All were symptomatic and required revision surgery. No malunions were identified in our sample. One hardware failure was documented in a nonunion patient. The mean time to osseous union was 81.7 ± 15.9 days. The preoperative AOFAS MTP-IP score was 55.6 and the postoperative score was 64.7.

Conclusion: The high nonunion and revision surgery rates demonstrate that this particular plate should be used with caution for a first MTP joint arthrodesis.

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

Keywords: arthrodesis; first metatarsophalangeal joint; fusion; nonunion; plate.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthrodesis / instrumentation*
  • Arthrodesis / methods
  • Bone Plates* / adverse effects
  • Female
  • Hallux / surgery*
  • Humans
  • Longitudinal Studies
  • Male
  • Metatarsophalangeal Joint / surgery*
  • Middle Aged
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Visual Analog Scale