Background: Fusion of the first metatarsophalangeal joint (1st MTPJ) is a common surgical procedure used to treat a variety of diseases and deformities of the forefoot. Fixation methods vary and typically fusion rates are good.
Objectives: The objectives of the study are to demonstrate whether there is any advantage to using locking as opposed to non-locking plates for 1st MTPJ fusion. Additionally the study aims to determine whether there is any difference in non-union rates according to gender.
Methods: One hundred and seventy two consecutive 1st MTPJ fusions were performed for 153 patients. 40 patients (23%) were male and 132 (77%) female. Twenty patients received Hallu-fix™ plates, 76 Charlotte™ plates and 76 Anchorage™ plates. Postoperative radiographs were reviewed for non-union. Failure rates were compared using Fisher's exact tests (p=0.05).
Results: Twelve (6.9%) non-unions were identified. The difference in failure rates between all systems was not statistically significant. However, the difference in fusion rates between males (17.5%) and females (3.8%) was significant.
Conclusion: This study finds that 1st MTPJ fusion is an effective method to treat diseases of the 1st MTPJ. Locking plates may offer better fusion rates than their non-locking counterparts. This is especially evident in male patients.
Keywords: First; Fusion; Joint; Locking; Metatarsophalangeal; Non-locking.
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