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FIRST METATARSOPHALANGEAL JOINT FUSION FOR HALLUX RIGIDUS, RELATIONSHIP OF FUNCTIONAL OUTCOME AND FOOT PRESSURE STUDY



Abstract

Arthrodesis of 1st MTP joint is a reliable procedure for hallux rigidus. We have studied the effects of first MTP joint arthrodesis on activities of daily living and leisure activities

Methods: We retrospectively evaluated 103 1st MTP fusion, done by a single orthopaedic surgeon with special interest in foot surgery over seven years period. All patient underwent two cross screw fixation for primary operation. Same operative technique was used in all patients.

We evaluated pre op scoring for pain, walking distance, walking up hill – stairs, foot wear, return to leisure activity and work, chronicity of symptoms, associated symptoms, radiological appearance pre op, post op and at radiological fusion and complication rate.

All patients were followed up.

The patients were contacted with questionnaire to evaluate the function after the fusion.

The patients were asked whether they would participate in the foot pressure study; which was done with the help of podiatrist at same trust.

We have tried to correlate the functional outcome and its relation to foot pressure.

Results: Fusion was achieved in all patients. (three after revision). Pain scores evaluated using the visual analogue scale, indicated effective pain relief. High levels of return to functions were noted. The pressure (under 1st or 2nd Metatarsal heads or laterally) study has revealed a pattern of changes with various symptoms.

Conclusion: Arthrodesis of first MTP joint, using two cross screws, is a successful surgical technique for Hallux rigidus and also allows high level of function in daily activities of living and leisure activities.

Correspondence should be addressed to the Honorary Secretary, BOFSS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.