Hi, my name is Logan Reed and today I'm going to be presenting Intermetatarsal Screw Fixation Reduced Intermetatarsal Angle Following Modified Laparoscopic Procedures. The study was conducted at the University of Alabama, Birmingham in the Department of Orthopedics, under the supervision of Michael Johnson. We have no disclosures to discuss. The modified laparoscopic arthrodesis is a historically established surgical technique for the treatment of hallux valgus. It provides quality patient outcomes and reproducible results. Addition of a transverse first to second intermetatarsal screw spanning the base of the metatarsals in this procedure can increase stability. No study evaluates the radiographical parameters following application of this intermetatarsal screw fixation to procedures without first to second intermetatarsal screw fixation. The purpose of the study was to assess the quality of radiographic parameters between individuals receiving a first to second intermetatarsal screw to those that did not receive the screw fixation following a non-saw cut modified laparoscopic procedure. We conducted a retrospective review performed on 74 patients that underwent a modified laparoscopic arthrodesis between 2016 and 2020 at a single level one institution. Preoperative indications for procedures included first-ray instability, first-ray hypermobility, hallux abductus valgus, and metatarsal primus elevatus. Inclusion criteria consisted of skeletomotor patients undergoing non-saw cut modified laparoscopic procedure. Patients that received the procedure due to traumatic event or patients with concomitant second metatarsal arthrodesis were excluded. A review of patient chart was performed, basic demographic data, implant type, and radiographic parameters including intermetatarsal angle and first metatarsal length were obtained from preoperative as well as postoperative films. In the total, with the total of 74 patients undergoing a modified laparoscopic arthrodesis included in the study, 43 of the patients received modified laparoscopic arthrodesis with the addition of first to second intermetatarsal screw fixation compared to 31 patients who only received the modified laparoscopic arthrodesis procedure. The average intermetatarsal angle in all patients prior to surgery was 13 degrees. The patients who received intermetatarsal screw fixation had significantly higher intermetatarsal angle reductions between preoperative and postoperative films than those who did not receive the intermetatarsal screw. The difference in first metatarsal length on preoperative and postoperative films was less in patients who received the screw fixation, but this was not statistically significant. In conclusion, the modified laparoscopic arthrodesis procedure is a commonly used procedure to treat hallux valgus. The results of this study found that the addition of a first to second intermetatarsal screw significantly reduced the intermetatarsal angle when compared to individuals who did not receive the screw construct. These findings will help surgeons further delineate if an intermetatarsal screw is required and how it will contribute to the radiographic parameters of interest.

intermetatarsal screw fixation

radiographic parameters

retrospective review

intermetatarsal angle

surgeons