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Foot Ankle Int. 2019 May 5:1071100719847700. doi: 10.1177/1071100719847700. [Epub ahead of print]

Multicenter Early Radiographic Outcomes of Triplanar Tarsometatarsal Arthrodesis With Early Weightbearing.

Author information

1
1 Department of Orthopaedics, West Virginia University, Morgantown, WV, USA.
2
2 Department of Radiology, West Virginia University, Morgantown, WV, USA.
3
3 Foot & Ankle Center of Iowa, Ankeny, IA, USA.
4
4 Department of Podiatric Medicine and Surgery, North Colorado PMS Residency, Greeley, CO, USA.
5
5 Orthopedics, University of South Carolina, Palmetto Health-USC Orthopedic Center, Lexington, SC, USA.

Abstract

BACKGROUND:

Hallux valgus is a multiplanar deformity of the first ray. Traditional correction methods prioritize the transverse plane, a potential factor resulting in high recurrence rates. Triplanar first tarsometatarsal (TMT) arthrodesis uses a multiplanar approach to correct hallux valgus in all 3 anatomical planes at the apex of the deformity. The purpose of this study was to investigate early radiographic outcomes and complications of triplanar first TMT arthrodesis with early weightbearing.

METHODS:

Radiographs and charts were retrospectively reviewed for 57 patients (62 feet) aged 39.7 ± 18.9 years undergoing triplanar first TMT arthrodesis at 4 institutions between 2015 and 2017. Patients were allowed early full weightbearing in a boot walker. Postoperative radiographs were compared with preoperative radiographs for hallux valgus angle (HVA), intermetatarsal angle (IMA), tibial sesamoid position (TSP), and lateral round sign. Any complications were recorded.

RESULTS:

Radiographic results demonstrated significant improvements in IMA (13.6 ± 2.7 degrees to 6.6 ± 1.9 degrees), HVA (24.2 ± 9.3 degrees to 9.7 ± 5.1 degrees), and TSP (5.0 ± 1.3 to 1.9 ± 0.9) from preoperative to final follow-up ( P < .001). Lateral round sign was present in 2 of 62 feet (3.2%) at final follow-up compared with 52 of 62 feet (83.9%) preoperatively. At final follow-up, recurrence was 3.2% (2/62 feet), and the symptomatic nonunion rate was 1.6% (1/62 feet). Two patients required hardware removal, and 2 patients required additional Akin osteotomy.

CONCLUSION:

Early radiographic outcomes of triplanar first TMT arthrodesis with early weightbearing were promising with low recurrence rates and maintenance of correction.

LEVEL OF EVIDENCE:

Level IV, retrospective case series.

KEYWORDS:

bunion; hallux valgus; modified Lapidus; tarsometatarsal arthrodesis; triplanar

PMID:
31056950
DOI:
10.1177/1071100719847700

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