Corrective Realignment Arthrodesis of the First Tarsometatarsal Joint Without Wedge Resection.

Foot Ankle Spec

CORE Institute, Phoenix, Arizona (JEM), Suburban Orthopadeics, Bartlett, IL (KSP) and Orthopedic Foot and Ankle Center, Westerville, Ohio (CFH)

Published: August 2015

Unlabelled: Moderate to severe hallux valgus (HV) has traditionally been treated with a corrective osteotomy or a tarsometatarsal arthrodesis. Tarsometatarsal arthrodesis can be performed as a planar wedge resection or using a joint curettage technique. Little is known about whether adequate correction can be obtained with purely a joint curettage technique. The purpose of this study is to evaluate the corrective power of a first tarsometatarsal joint (TMTJ) arthrodesis using a nonplanar wedge curettage technique. A retrospective radiograph and chart review was performed on 99 consecutive patients (110 feet) who underwent a first TMTJ arthrodesis for primary HV correction utilizing a curettage technique. The radiographic measurements collected were the first intermetatarsal angle, HV angle, and tibial sesamoid position and were obtained at the following intervals: preoperative, immediate postoperative, and 6 months postoperative. In all, 91 patients (100 feet) qualified for statistical analysis. There was a significant decrease in all 3 measurements from the preoperative throughout the entire postoperative time period (P < .001). The authors demonstrate the ability to achieve significant angular correction with a joint curettage method for a tarsometatarsal arthrodesis.

Levels Of Evidence: Therapeutic, Level IV: Case series.

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Source
http://dx.doi.org/10.1177/1938640014560167DOI Listing

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