Arthrodesis of the First Metatarsophalangeal Joint: A Biomechanical Study of Internal Fixation Techniques

This study compares the strength and rigidity of four methods of internal fixation for arthrodesis of the first metatarsophalangeal joint. Ten matched pairs of cadaveric first rays were harvested and arthrodesis performed by one of four techniques: (1) planar excision of joint surfaces and fixation with crossed Kirschner wires, (2) planar excision of joint surfaces and internal fixation with a dorsal plate and screws, (3) planar excision of joint surfaces and internal fixation with an interfragmentary screw, or (4) excision of the joint surfaces using powered conical reamers and fixation with an interfragmentary lag screw. Biomechanical testing with a Bionix 858 materials testing machine was carried out, applying a plantar force utilizing principles of cantilever loading. Force applied and displacement of the arthrodesis were recorded. Of the four methods tested, bony preparation with power conical reamers and supplementary interfragmentary screw fixation was the most stable.

[1]  P. Gregg,et al.  The management of the painful first metatarsophalangeal joint in the older patient. Arthrodesis or Keller's arthroplasty? , 1990, The Journal of bone and joint surgery. British volume.

[2]  U. Lindgren,et al.  Compression-screw arthrodesis of the first metatarsophalangeal joint of the foot. , 1987, Clinical orthopaedics and related research.

[3]  A. Hughes,et al.  A Biomechanical Study Using Cadaveric Toes to Test the Stability of Fixation Techniques Employed in Arthrodesis of the First Metatarsophalangeal Joint , 1986, Foot & ankle.

[4]  A. U. Daniels,et al.  Comparison of internal fixation techniques in metacarpal fractures. , 1985, The Journal of hand surgery.

[5]  F. Kummer,et al.  Stiffness of small-bone external fixation methods: an experimental study. , 1984, The Journal of hand surgery.

[6]  W. Skelton,et al.  A strain recording model: analysis of transverse osteotomy fixation in small bones. , 1984, The Journal of hand surgery.

[7]  J. Sanger,et al.  The comparative strengths of internal fixation techniques. , 1984, The Journal of hand surgery.

[8]  N. Langrana,et al.  A phalangeal fracture model--quantitative analysis of rigidity and failure. , 1982, The Journal of hand surgery.

[9]  R A Mann,et al.  Arthrodesis of the First Metatarsophalangeal Joint , 1980, Foot & ankle.

[10]  I. Fyfe,et al.  The Mechanical Stability of Internal Fixation of Fractured Phalanges , 1979, The Hand.

[11]  J. Kopta,et al.  Metatarsophalangeal joint fusion of the great toe. , 1978, Orthopedics.

[12]  W Waugh,et al.  The use of footprints in assessing the results of operations for hallux valgus. A comparison of Keller's operation and arthrodesis. , 1975, The Journal of bone and joint surgery. British volume.

[13]  L L Wiltse,et al.  Preoperative psychological tests as predictors of success of chemonucleolysis in the treatment of the low-back syndrome. , 1975, The Journal of bone and joint surgery. American volume.

[14]  J. Fitzgerald.  A review of long-term results of arthrodesis of the first metatarso-phalangeal joint. , 1969, The Journal of bone and joint surgery. British volume.

[15]  Marin Ga.  Arthrodesis of the metatarsophalangeal joint of the big toe for hallux valgus and hallux rigidus. A new method. , 1968 .

[16]  F. Moynihan.  Arthrodesis of the metatarso-phalangeal joint of the great toe. , 1967, The Journal of bone and joint surgery. British volume.

[17]  M. Swiontkowski,et al.  Torsion and bending analysis of internal fixation techniques for femoral neck fractures: The role of implant design and bone density , 1987, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[18]  R A Mann,et al.  Arthrodesis of the first metatarsophalangeal joint as salvage for the failed Keller procedure. , 1987, The Journal of bone and joint surgery. American volume.

[19]  F. Kummer,et al.  The effect of immobilization devices on the load distribution under the foot. , 1985, Clinical orthopaedics and related research.