The Outcome of the Use of Continuous Action Compression Device for the First Metatarsophalangeal Joint Fusion.

Introduction: First metatarsophalangeal (MTP) joint fusion is a widely accepted surgical intervention for treating severe arthritis, deformities, and instability of the first MTP joint. This paper provides a review of a single surgeon's experience with continuous compression implants (CCI), which offer a notable advantage by providing uniform compression across a larger surface area of the fusion site compared to plate and screw constructs. This design potentially reduces soft tissue irritation and, consequently, the need for subsequent implant removal. It also saves on cost and has the potential to reduce the length of surgery.

Methods:  A retrospective review was conducted on 27 patients (n=36 feet) who underwent primary first metatarsophalangeal joint (MTPJ) fusion using continuous compression implants (CCI) between March 2020 and April 2024 at Bradford Royal Infirmary. Patient data were collected from the surgeon's logbook and medical records. The outcomes analyzed included the fusion rate and complications. Statistical analysis was performed using SPSS version 22.0, with p<0.05 considered significant.

Results:  The mean age of the cohort was 60.24 years (range 41-90), with 88.88% female. The ratio of left to right was 70%. The mean follow-up duration was 27 months (range 6-48 months). Complete fusion of the first MTPJ was achieved in 34 out of 36 feet (94.4%). Nonunion occurred in one patient, while delayed union was observed in another. Clinically, 35 out of 36 patients (97.3%) reported satisfaction with the procedure, with one patient requiring metalwork removal and revision due to loosening.

Conclusion: Early results show that the rate of fusion achieved by using the CCI for the first MTPJ arthrodesis in our series was comparable to that of other devices quoted in the literature.