Interfragmentary screw with dorsal locking diamond plate (IS-DLDP): A novel use of a midtarsal construct for first metatarsal phalangeal joint arthrodesis

Abstract

Arthrodesis is an indication for treating a variety of pathologies to the first metatarsophalangeal joint (MTPJ), which include arthritis, deformities related to traumatic injuries, and other derangements. This case report describes a novel technique utilizing an interfragmentary screw with a two-hole dorsal locking diamond plate (IS-DLDP) midfoot construct for the first MTPJ arthrodesis. Studies describing the biomechanical superiority of the dorsal plate with a lag screw construct for the first MTPJ fusion have frequently referenced the four-hole and five-hole plates. The current study aims to justify the IS-DLDP midfoot construct with an interfragmentary screw as an alternative to the four-hole or five-hole plate with an interfragmentary lag screw construct for the first MTPJ. The IS-DLDP construct offers deformity correction with an ultra-low-profile plating system, short operating time due to ease of placement, decreased radiation and anesthesia exposure, easy visualization of bone healing in all radiographic foot views, DVT prevention through immediate weight-bearing, and transition to pain-free ambulation in sneakers by four weeks.

Keywords

• Arthrodesis
• First metatarsophalangeal joint
• Diamond plate
• Hallux abducto-valgus
• Hallux limitus
• Hallux rigidus