High Incidence of Non-Union Following Arthrodesis of the First Metatarsophalangeal Joint

Abstract

Background: Non-union is a complication after arthrodesis of the first metatarsophalangeal joint (MTP-1). The reported incidence varies from 0 to 12%. However, we suspected the incidence might be higher in our clinic. The purpose of this study was to determine the incidence of non-union after MTP-1 arthrodesis.Methods: In a retrospective cohort study, all patients that underwent primary MTP-1 arthrodesis between January 2015 and December 2016 were analysed.Results: 89 toes were included among 84 patients. The cohort consisted of 63 females and 26 males with an average age of 60. The incidence of non-union was 23.5%. No significant differences in means of hallux valgus angle (HVA), age, smoking habits, ASA classification, gender, screw length, surgery duration, the number of bony cortices involved in the fixation, position of the screw intersection, fixation technique, articular surface preparation and the attending surgeon were found.Conclusion: The incidence of non-union following MTP-1 arthrodesis is substantially higher compared to previously reported numbers in literature. No cause regarding the latter was identified. In an attempt to reduce the incidence of non-union, we have recently adjusted our treatment protocol and surgery techniques.