Article published: Union rates in hallux interphalangeal joint arthrodesis.

Dr FJ du Toit and Dr JJ Naude recently collaborated with renowned foot and ankle specialists to publish an article on union rates in hallux interphalangeal joint arthrodesis. 

As foot and ankle surgeons, we aim to provide our patients with the best possible outcomes following surgical procedures. One such procedure we frequently perform is the hallux interphalangeal joint arthrodesis (HIPJA). Our recent study, published in the Foot and Ankle Journal, focused on assessing the radiographic union rate and complications associated with this surgery, using a consistent surgical technique. Here’s what we found.

The primary goal was to evaluate the effectiveness of a reproducible surgical technique for HIPJA and to highlight potential tips that could enhance the union rate after surgery. We conducted a retrospective review of all HIPJA surgeries performed by our team of four orthopaedic surgeons. Key factors such as surgical technique, patient demographics, indications for surgery, reoperation rates, complications, and radiographic evidence of arthrodesis were meticulously analysed. Radiographic union was defined by specific criteria, including the presence of two cortical continuations or trabecular bridging, absence of hardware failure, and no lytic gapping at the surgery site.

In our study, we identified 35 primary HIPJA procedures with follow-up imaging to confirm either union or non-union. Remarkably, we achieved a 97.1% radiographic union rate, with an average time to union of 20 weeks. Out of the cohort, there were three reoperations:

• Two cases (5.7%) were for removal of painful hardware.

• One case (2.9%) was for revision of a symptomatic non-union.

 Notably, only one non-union occurred, which limited our ability to identify independent predictors for non-union.

Our findings indicate that a consistent surgical technique, careful joint preparation, and the use of a single large intramedullary differential pitch screw for fixation contribute to a high radiographic union rate. However, we observed that the time to achieve union was longer than anticipated, averaging 20 weeks. For patients considering or preparing for HIPJA, understanding these outcomes can help set realistic expectations about recovery and the healing process.

As always, our focus remains on delivering the highest quality of care and improving surgical techniques for better patient outcomes.

Read the full article here: https://jfootankle.com/JournalFootAnkle/article/view/2115