In:
Foot & Ankle International, SAGE Publications, Vol. 43, No. 1 ( 2022-01), p. 77-85
Kurzfassung:
Tarsometatarsal (TMT) arthrodesis is a common operative procedure for end-stage arthritis of the TMT joints. To date, there is no consensus on the best fixation technique for TMT arthrodesis and which joints should be included. Methods: Thirty fresh-frozen feet were divided into one group (15 feet) in which TMT joints I-III were fused with a lag screw and locking plate and a second group (15 feet) in which TMT joints I-III were fused with 2 crossing lag screws. The arthrodesis was performed stepwise with evaluation of mobility between the metatarsal and cuneiform bones after every application or removal of a lag screw or locking plate. Results: Isolated lag-screw arthrodesis of the TMT I-III joints led to significantly increased stability in every joint ( P 〈 .05). Additional application of a locking plate caused further stability in every TMT joint ( P 〈 .05). An additional crossed lag screw did not significantly increase rigidity of the TMT II and III joints ( P 〉 .05). An IM screw did not influence the stability of the fused TMT joints. For TMT III arthrodesis, lag-screw and locking plate constructs were superior to crossed lag-screw fixation ( P 〈 .05). TMT I fusion does not support stability after TMT II and III arthrodesis. Conclusion: Each fixation technique provided sufficient stabilization of the TMT joints. Use of a lag screw plus locking plate might be superior to crossed screw fixation. An additional TMT I and/or III arthrodesis did not increase stability of an isolated TMT II arthrodesis. Clinical Relevance: We report the first biomechanical evaluation of TMT I-III arthrodesis. Our results may help surgeons to choose among osteosynthesis techniques and which joints to include in performing arthrodesis of TMT I-III joints.
Materialart:
Online-Ressource
ISSN:
1071-1007
,
1944-7876
DOI:
10.1177/10711007211033541
Sprache:
Englisch
Verlag:
SAGE Publications
Publikationsdatum:
2022
ZDB Id:
2129503-7
