Institution: Imperial College and The Fortius Clinic, London, UK.Ĭlinicians should seek clarification on whether any implant demonstrated is licensed for use in their own country. įirst MTP Fusion: Revision of failed Kellers using DocPrice plate and vascularised allograft.įirst MTP Fusion-Crossed screws technique.īone block first MTP fusion using the Wright Ortholoc plate Readers will also find of interest the following OrthOracle techniques:įirst MTP Fusion :Coughlin reamer preparation and Orthosolutions Cannulated 4mm screws.įirst MTP Fusion (using Stryker Anchorage MTP arthrodesis plate )for Hallux Varus. I particularly like the Synthes system of compression through the plates, using the combination of compression wires and a clamp – the final construct is secure enough that no lag screw is needed. This also provides a large surface area of cancellous bone contact for rapid union. This allows completely versatile positioning of the hallux due to the “ball & socket” fusion surface. I prefer to prepare the joint with spherical reamers on the VA instrument set – these are cup and ball reamers of differing sizes. I most often use the middle length plate (42mm) in 0 degrees. The plates come in 3 different angles – 0, 5 & 10 degrees of dorsiflexion and in 3 different lengths.
The plate profile is curved for strength and also to fit the anatomy well – this gives it a low profile and rarely needs removal. This allows the screws to be positioned well and avoid any underlying metal work (often found in revision cases!). The Synthes locking plates are low profile, with variable angle locking holes & screws. This plate provides a very strong construct and allows comfortable walking early in the post op period. The technique detailed in this operation is using the Synthes MTP fusion plate – its a Dorsal Locking Plate. There are various ways of fixing the fusion, most commonly a single axial compressive screw combined with a dorsal neutralising or compression plate. Its most commonly done for end stage arthritis or hallux rigidus and also for severe hallux valgus.
Return to full daily activity is rapid after a few weeks, but high endurance or sports will only take a few months. The union and success rates are well above 90% and in general, the risks and complications are rare.
The function afterwards is excellent and even allows professional sports such as tennis or football. Our e-learning platform contains high resolution images and a certified CME of the First MTP fusion (hallux rigidus): Dorsal approach with Synthes MTP fusion plate surgical procedure.Ī 1st MTP joint fusion is an extremely successful operation with very high levels of patient satisfaction when done well. Learn the First MTP fusion (hallux rigidus): Dorsal approach with Synthes MTP fusion plate surgical technique with step by step instructions on OrthOracle. Subscribe to get full access to this operation and the extensive Foot Surgery Atlas.