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Early Results and Patient-Reported Outcome Measures (PROMS) of an Intraosseous Device for Arthrodesis of the First Tarso-Metatarsal (TMT) Joint

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Abstract

Background

We describe a new surgical technique for arthrodesis of the first tarso-metatarsal (TMT) joint using an intraosseous fixation device and the early results including patient-reported outcome measures (PROMS).

Materials and Methods

Seventeen consecutive procedures with this method were included. Indication for surgery was hallux valgus. The average age was 42 years (range 26–65). PROMS were collected and the patients were asked to fill out a satisfaction questionnaire. A retrospective review of radiographs and electronic medical notes was conducted.

Results

Overall fusion rate was 94%. Complications included a case of failed fusion, a superficial wound infection and a deep vein thrombosis (DVT). At a mean follow-up of 24 months (range 10–38) radiographic results demonstrated significant improvement in the intermetatarsal angle or IMA (11.7 ± 2.8 degrees to 6.9 ± 2.4 degrees, P < 0.001) and hallux valgus angle or HVA (28.1 ± 7.3 degrees to 12.2 ± 4.3 degrees, P < 0.001). The mean visual analog scale (VAS) score improved significantly from a mean of 7.6 (SD 0.85) preoperatively, to a mean of 2.1 (SD 1.83) post-operatively (P < 0.0001). The Manchester–Oxford Foot Questionnaire (MOXFQ) significantly improved from a mean of 35.8 (SD 10.2), to a mean of 9.2 (SD 17) (P < 0.0001). The final result was satisfactory for 88% of the patients.

Conclusions

The early results show intraosseous fixation to be a safe and efficient method for the fusion of the first TMT joint providing good patient satisfaction.

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Fig. 1 

Source: a https://www.extremitymedical.com/lower-extremity/io-fix/. b Extremity medical IO Fix surgical technique handbook

Fig. 2

Source: a, b Extremity medical IO Fix surgical technique handbook

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Author information

Author notes

  1. Joint first authorship is allocated to Mr. Levent Bayam and Mr. Paul Ryan as both contributed equally to this paper.

Authors and Affiliations

  1. Manchester Royal Infirmary Orthopaedic Department, Manchester, UK

    Levent Bayam, Muhammad Bilal, Irfan Fayyaz & Efstathios Drampalos

  2. Orthopaedic Department, Forth Valley Royal Hospital, Larbert, Scotland, UK

    Paul Ryan & Efstathios Drampalos

Authors
  1. Levent Bayam
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  2. Paul Ryan
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  3. Muhammad Bilal
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  4. Irfan Fayyaz
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  5. Efstathios Drampalos
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Correspondence to Paul Ryan.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study was authorized by the local ethical committee as part of the Clinical Effectiveness & Audit Department (Registered number 8661) and was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki as revised in 2000.

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Informed Consent consent was taken from all patients included in the study.

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Bayam, L., Ryan, P., Bilal, M. et al. Early Results and Patient-Reported Outcome Measures (PROMS) of an Intraosseous Device for Arthrodesis of the First Tarso-Metatarsal (TMT) Joint. JOIO 56, 895–901 (2022). https://doi.org/10.1007/s43465-021-00572-6

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  • DOI: https://doi.org/10.1007/s43465-021-00572-6

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