Reduction of the Intermetatarsal Angle after First Metatarsal Phalangeal Joint Arthrodesis: A Systematic Review

Arthrodesis of the first metatarsophalangeal joint (MTPJ) has commonly been used for the treatment of a variety of first MTPJ disorders, including hallux valgus. We undertook a systematic review of the electronic databases and other relevant sources to identify material relating to the reduction of the first intermetatarsal angle (IMA) after first MTPJ arthrodesis. Fifteen studies with a total of 701 first MTPJ arthrodesis procedures were identified that met the inclusion criteria. Our results showed the mean preoperative IMA was 13.74 degrees and the mean postoperative IMA was 9.38 degrees, for a mean change in the IMA of 4.36 degrees. The data were analyzed further in 2 subsets. The first subset included 8 studies (434 procedures) that reported a mean preoperative IMA of less than 15 degrees. The mean change in the IMA in this group was 3.70 degrees. The second subset included 7 studies (267 procedures) that reported a mean preoperative IMA of greater than 15 degrees. The mean change in the IMA in this group was 5.42 degrees. The results of the present systematic review have confirmed that a significant reduction of the first IMA can be achieved by first MTPJ arthrodesis alone and that additional procedures to correct the IMA will not be necessary. (C) 2014 by the American College of Foot and Ankle Surgeons. All rights reserved.