Functional Results & Satisfaction of First Metatarsophalangeal Joint Arthrodesis

Dr. Peter Blume has Published Functional Results and Patient Satisfaction of First Metatarsophalangeal Joint Arthrodesis Using Dual Crossed Screw Fixation

I am very pleased with the results. It demonstrates that a solid fusion of the first metatarsal phalangeal joint provides an excellent solution for chronic arthritis and deformities of the great toe.”
— Peter Blume

NEW HAVEN, CT, USA, April 20, 2017 / -- Dr. Peter Blume, Assistant Clinical Professor of Surgery, Cardiology, Anesthesia and Orthopedics and Rehabilitation, Yale School of Medicine and Co-Director of CLI at the Yale New Haven Hospital has recently published a landmark paper on great toe fusions in the prestigious publication, The Journal of Foot and Ankle Surgery. This was the largest series of fusion procedures of the great toe published to date. Dr. Blume was the senior author who himself completed all of the surgeries with respect to the series that was published and was also a co-author with Dr. Ryan Donegan. The study demonstrated the utilization of a cross screw technique for arthrodesis of the first metatarsal phalangeal joint which revealed an excellent solution to arthritis of the great toe.


A total of 262 feet in 228 consecutive patients underwent first metatarsophalangeal joint (MPJ) fusion; thus, the present study is the largest single-surgeon patient series reported. The inclusion criteria included severe painful deformity of the first MPJ due to osteoarthritis, rheumatoid arthritis, or gouty arthritis and stage 3 or 4 hallux rigidus. The exclusion criteria were revision surgery of the first MPJ, fixation other than with dual crossed screws, and a postoperative follow-up period of <3 months. Fusion of the first MPJ was fixated with dual-crossed 3.0-mm screws. The office follow-up period was ≥3 months postoperatively and the survey follow-up period was ≥6 months postoperatively. The mean duration to radiographic evidence of arthrodesis was 7.00 ± 2.33 weeks, and 252 of the feet (96.18%) achieved successful arthrodesis. The mean postoperative office follow-up duration was 30.43 ± 6.59 weeks. The mean modified American College of Foot and Ankle Surgeons scale score was 51.2 ± 3.28 of maximum possible of 68 points. The mean subjective score was 37.1 ± 2.5 (maximum possible of 50 points), and the mean objective score was 14.5 ± 1.7 (maximum possible of 18 points). Furthermore, 200 patients (87.72%) reported that they had little to no pain, 187 (82.02%) reported they either mostly liked the appearance of their toe or liked it very much, and 173 (75.88%) reported that they could wear any type of shoe most or all the time after the operation. Of the respondents, 207 (90.79%) stated they would have the surgery repeated, and 197 (86.40%) would recommend the surgery to a family member or friend.

Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.


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