Arthrodesis of the metatarsophalangeal joint of the great toe with Herbert screws: a clinical analysis of 27 cases.

Abstract

A clinical analysis of 27 cases of arthrodesis of the great toe with Herbert screws, which include 5 male and 22 female patients with an average age of 60.2 years and an average follow-up period of of 14.1 months was accomplished. The data reveals an average reduction of the first metatarsophalangeal angle from 31.4 degrees to 17.5 degrees (a 44.3% reduction). The first intermetatarsal angle decreased from 11.9 degrees to 8 degrees (a 32.8% reduction). Lateral subluxation of the sesamoids changed from 6.2 to 4.6 mm. (a 25.8% reduction). Distance between the centers of the first and fifth metatarsal heads changed from 73.6 to 68.2 mm. (a 7.3% reduction of ball width), with an average postoperative dorsiflexion of the first metatarsophalangeal joint of 22.0 degrees. The evaluation includes 25 cases (92.6%) of satisfactory results and 2 cases (7.4%) of unsatisfactory results. Unsatisfactory cases were caused by technical errors, which produced insufficient dorsiflexion and excessive lateral deviation of the great toe. No incidence of nonunion was encountered in this series.