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First MTP Fusion-Crossed screws technique. surgical technique

Overview

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Learn the First MTP Fusion-Crossed screws technique. surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the First MTP Fusion-Crossed screws technique. surgical procedure.

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 as well as appropriate patient selection and expectation management.

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.

Similar techniques shown on OrthOracle are the use of Coughlin reamers for the joint preparation

https://www.orthoracle.com/library/first-mtp-fusion-coughlin-reamer-preparation-and-orthosolutions-cannulated-4mm-screws/  

also detailed on the platform is corrective MTP fusion of a hallux varus using a Stryker Anchorage plate

https://www.orthoracle.com/library/hallux-varus-correction-stryker-anchorage-mtp-arthrodesis-plate/

and the technique of bone block distraction MTP fusion for a short first ray

https://www.orthoracle.com/library/bone-block-first-mtp-fusion-using-the-wright-ortholoc-plate/

 

 

Author: Mark Herron FRCS.

Institution: The Wellington Hospital, London, UK.

 

 

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
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  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
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    The pass mark is 75%.
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CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity

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