[Retrospective study of the first metatarsophalangeal joint arthrodesis: 39 cases].

Background: The first metatarsophalangeal joint arthrodesis is a fusion with optimal alignment of the first metatarsal and first phalanx which conferring indolence, strength and stability.

Aim: The goal of this study was to evaluate the place of arthrodesis of the first metatarsophalangeal joint in surgery of the fore foot.

Methods: This work is based on analysis of records of 35 patients between 1995 and 2006. 39 first metatarsophalangeal joint arthrodesis were practice (3 were bilateral). They had a follow up of from three to ten years. All patients were called for a complete exploration radiographic and clinical evaluation according to the criteria of KITAOKA. The average age of patients was 54 years.

Results: They were 28 women and 7 men. The indications were hallux rigidus in 51% cases and rheumatoid arthritis in 41% cases. The procedure used mostly a stable fixation with a compressive screw. The dorsal flexion recommended is between 20 and 30°. Ankylosis of the ankle or the inter-phalangeal joint was an against indication for the first metatarsophalangeal joint arthrodesis. The study found a patient subjective satisfaction rate of 92 per cent, there was no pain for 89 per cent of cases. It was noted 4 non-fusion cases paradoxically with satisfactory functional result. There was no pain of inter-phalangeal joint in all cases when X-rays showed arthritis in 4 cases.

Conclusion: The first metatarsophalangeal joint arthrodesis, provided we respect a few simple principles, restores painless and satisfying function of foot.