First MTP Fusion-Crossed screws technique. surgical technique
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A 1st MTP (metatarsophalangeal ) joint fusion is a highly versatile operation both in terms of the conditions which can be treated as well as in terms of the function possible after successful fusion.
A union rate of 90% plus is recorded in most series using current techniques. Success defined in terms of patient satisfaction rates though can be slightly lower than those of radiographic union of the fusion .
The keys to operative success are careful joint preparation, positioning and appropriate fixation.
There are various ways of fixing the fusion, most commonly a single axial compressive screw combined with a dorsal neutralising or compression plate . The technique detailed in this operation is a “crossed-screws” technique which differs only in the final mode of fixation.
Author: Mark Herron FRCS.
Institution: The Wellington Hospital, London, UK.