Incidence of complications following tri-planar instrumented correction system for treatment of hallux valgus deformity: A case series

Abstract

Purpose: We present our incidence of osseous complications following 1 st tarsometatarsal joint arthrodesis utilizing a novel, 1 st generation tri-planar correction system for hallux valgus performed in a consecutive series of patients. Case Study: Twenty consecutive patients underwent 1 st TMTJ arthrodesis utilizing a tri-planar instrumented system. Serial radiographs were obtained to assess osseous complications, specifically: delayed-, mal-, non-union and hardware related problems, as well as, need for return to the operating room following the index procedure. Procedures: Tri-planar instrumented 1 st TMTJ arthrodesis was performed by the same surgeon. All patients were followed clinically for a minimum of 12-months’ time with serial radiographs performed as indicated. Results: 12 of the 20 feet reported osseous complications (60%) with 5 of these 12 patients (42%) requiring revision surgery. Complications encountered included hardware failure (n = 8), non-union (n = 3) and delayed-union (n = 1). Of those that required revision, 4 patients benefited from removal of the hardware alone with the remaining patient requiring an extended medial-column arthrodesis. The mean clinical follow-up was 29-months from the index surgery. Analysis and Discussion: Osseous complications are infrequent following 1st TMTJ arthrodesis for HV when performed by surgeons familiar with this approach. Despite this, instrumented surgery offers the potential to improve outcomes by reducing osseous and hardware related problems. Despite optimized patients and the same experienced surgeon performing 1st TMTJ arthrodesis, we encountered significant osseous complications in 60% of the patients treated including a need for surgical revision in 40% of those patients with complications.