O2414 INTERPOSITION GRAFT ARTHRODESIS AS A SALVAGE FOR FAILED ARTHROPLASTIES OF THE FIRST METATARSO-PHALANGEAL JOINT (KELLER AND HUETER)

Abstract

Aims: Failure after arthroplasties of þrst metatarso-phalangeal joint (MPJ) is relatively common because the instability and the insufþciency of the great toe; the Patients usually complaint for transfer metatarsalgia and secondary deformities of the lesser toes. The goal of the study is to evaluate a series of arthrodesis of þrst MPJ performed for failed Keller or Hueter procedures; in all cases bone grafts were used in order to restore the normal lenght of the þrst ray. Methods: Between 1996 and 2002 16 Patients were treated with this technique; there were 14 cases of failed Keller arthroplasty and 2 cases of failed Hueter procedure. In all cases tibial or iliac cortico-cancellous grafts were used. Stabilization was performed by 1.5 mm. K-wirws. In 10 cases additional procedures about lesser rays were used. Results: Evaluation of the results was made using AOFAS forefoot score with a minimum follow-up of 7 months (average 3.3 yrs). Fusion was achieved in all cases but one. Average time of fusion was 9 weeks. All Patients were satisfyed with the results in term of pain relief, function and cosmesis. Conclusions: Interposition graft arthrodesis is an effective procedure for failed arthroplasties of þrst MPJ.