First Metatarsophalangeal Joint Arthrodesis: A Retrospective Comparison of Crossed-screws, Locking and Non-Locking Plate Fixation with Lag Screw

Locking plate fixation is increasingly used for first metatarsophalangeal joint (MTP-I) arthrodesis. Still there is few comparable clinical data regarding this procedure.
We retrospectively evaluated 60 patients who received an arthrodesis of the MTP-I between January 2008 and June 2010. With 20 patients each we performed a locking plate fixation with lag screw, arthrodesis with crossed-screwsor with a nonlocking plate with lag screw.
There were four non-unions in crossed-screws patients and one nonunion in non-locked plate group. All the patients in locking plate group achieved union. 90% of the patients were completely or mildly satisfied in locking plate group, whereas this rate was 80% for patients in both crossed screws and non-locking plate groups.
Use of dorsal plating for arthrodesis of MTP1 joint either locking or non-locking were associated with high union rate and acceptable and comparable functional outcome. Although nonunion rate was high using two crossed screws but functional outcome was not significantly different compare to dorsal plating.