first metatarsophalangeal joint arthrodesis: a retrospective comparison of crossed-screws, locking and non-locking plate fixation with lag screw

Background: locking plate fixation is increasingly used for first metatarsophalangeal joint (mtp-i) arthrodesis. there are still few comparable clinical data regarding this procedure. in this study we aimed to compare the clinical and radiographical outcomes of crossed-screws, locking and non-locking plate fixation with lag screw for first metatarsophalangeal joint arthrodesis. methods: a total of 60 patients who had undergone arthrodesis of the mtp-i between january 2008 and june 2010 were retrospectively evaluated. locking plate fixation with lag screw as well as arthrodesis with crossed-screws or with a non-locking plate with lag screw was performed on three groups of 20 patients. results: there were four non-unions in patients with crossed-screws and one in non-locked plate group. all 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. conclusion: use of dorsal plating for arthrodesis of mtp-i joint, either locking or non-locking, were associated with high union rate and acceptable and comparable functional outcome. although the rate of nonunion was higher with two crossed-screws, however, the functional outcome was not significantly different compared to dorsal plating.