CME OnDemand: 2022 AOFAS Annual Meeting-Does a 1st Metatarsophalangeal Fusion in a Patient with Pes Planus Improve the Pes Planus Deformity? A Retrospective Case Series

Does a 1st Metatarsophalangeal Fusion in a Patient with Pes Planus Improve the Pes Planus Deformity? A Retrospective Case Series

Back to course

Pdf Summary

This retrospective case series aimed to analyze the effect of 1st metatarsophalangeal joint (MTPJ) fusion on the pes planus deformity. Pes planus is a condition characterized by the flattening of the longitudinal arch of the foot. The study hypothesized that there would be no difference in the deformity before and after the fusion procedure.<br /><br />The researchers identified all cases of 1st MTPJ fusion from January 2011 to October 2021. Inclusion criteria required pre- and post-operative weightbearing radiographs and a Meary's angle of >4 degrees on the pre-operative imaging. Pes planus measurements were taken by two independent observers. Statistical tests were used to assess significant changes in the measurements.<br /><br />Results showed that 1st MTPJ fusion led to a significant improvement in axial alignment of the foot and a reduction in Meary's angle. However, diagnostic criteria for pes planus remained in most cases. Other measurements, such as talo-navicular coverage angle, intermetatarsal angle, and talo-navicular angle, also showed significant improvements.<br /><br />Out of 511 identified operations, 61 feet met the inclusion criteria. The mean patient age was 61 years. Post-operative Meary's angle was below 4 degrees in only 14.8% of cases. Additional forefoot procedures were performed in some cases.<br /><br />In conclusion, the study suggests that 1st MTPJ fusion can improve the axial alignment of the foot and reduce Meary's angle in patients with pes planus deformity. However, diagnostic criteria for pes planus may still be present in most cases. Further research and long-term follow-up are needed to better understand the effects of this procedure on pes planus deformity.

Asset Subtitle

James Chapman, Hollie Jenkinson, Neel Dalal, Grace L. Airey, Andrew P. Molloy, MB ChB, FRCS(Tr&Orth), Anjani K. Singh, MBBS, MRCS, FRCS(Tr&Orth), Siva Sirikonda, Lyndon W. Mason, MB BCh, MRCS(Eng), FRCS(TR&Orth), FRCS(Glasg)

Keywords

retrospective case series

1st metatarsophalangeal joint fusion

pes planus deformity

flattening of longitudinal arch

weightbearing radiographs

Meary's angle

axial alignment

talo-navicular coverage angle

intermetatarsal angle

talo-navicular angle