Our Summary

This research paper looks at a common foot deformity called hallux valgus disease. There are many ways to treat this surgically, but one method that’s gaining popularity is fusing a certain joint in the foot, despite the fact that 5 to 15% of cases result in the bone not healing properly.

The researchers compared three different tools that are commonly used to keep the bones in place during healing. They simulated the pressure that would be put on the foot after surgery to see how each tool performed.

They found that a tool called the plantar locking plate kept the joint the most stable under pressure. Another tool, the intramedullary device, was the best at initially pressing the bones together. However, the order in which the tools failed under pressure was: the intramedullary device, a plate located on the inside of the foot, and then the plantar locking plate.

In conclusion, the intramedullary device was the best at pressing the bones together initially, but the plantar locking plate was the most sturdy under pressure. The authors suggest that more research is needed to determine whether patients using the intramedullary device might need to avoid putting weight on their foot for longer to allow for better healing.

FAQs

  1. What is hallux valgus disease and how is it commonly treated?
  2. What tools were compared in the study for keeping the bones in place during healing after foot surgery?
  3. What were the findings of the study in terms of which tool was most effective at pressing the bones together initially and which was most sturdy under pressure?

Doctor’s Tip

A doctor might tell a patient undergoing joint fusion to follow post-operative instructions carefully, including avoiding putting weight on the foot for a certain amount of time to allow for proper healing. Additionally, they may recommend using a plantar locking plate for stability during the healing process based on research findings. It is important for patients to communicate any concerns or issues with their doctor during the recovery period to ensure the best possible outcome.

Suitable For

Patients who are typically recommended joint fusion are those with severe hallux valgus disease that has not responded to conservative treatments such as orthotics, shoe modifications, and physical therapy. Patients may also be recommended for joint fusion if they have significant pain, deformity, or difficulty walking due to their condition. Additionally, patients who have tried other surgical procedures such as bunionectomy and have not achieved satisfactory results may also be candidates for joint fusion.

Timeline

Before joint fusion:

  1. Patient experiences pain, stiffness, and swelling in the affected joint.
  2. Patient may have tried conservative treatments such as physical therapy, medications, or orthotics without success.
  3. Patient consults with a doctor who recommends joint fusion surgery as a treatment option.

After joint fusion:

  1. Patient undergoes joint fusion surgery, where the affected bones are fused together using screws, plates, or other tools.
  2. Patient may need to use crutches or a walking boot for support during the initial recovery period.
  3. Patient undergoes physical therapy to regain strength and range of motion in the affected joint.
  4. Patient gradually resumes normal activities and may experience improved stability and reduced pain in the joint after successful fusion.
  5. Patient continues to follow up with their doctor for monitoring and to address any potential complications or issues with healing.

What to Ask Your Doctor

Some questions a patient should ask their doctor about joint fusion for hallux valgus disease include:

  1. What are the potential risks and complications associated with joint fusion surgery?
  2. How long is the recovery process after joint fusion surgery?
  3. Will I need to undergo physical therapy after surgery?
  4. How long will I need to avoid putting weight on the foot after surgery?
  5. What type of tool or device will be used to keep the bones in place during healing?
  6. What is the success rate of joint fusion surgery for hallux valgus disease?
  7. Are there any alternative treatments to joint fusion that I should consider?
  8. How long do the effects of joint fusion surgery typically last?
  9. Will I experience any limitations in movement or activity after joint fusion surgery?
  10. How often will I need to follow up with you after the surgery for monitoring and check-ups?

Reference

Authors: Burchard R, Massa R, Soost C, Richter W, Dietrich G, Ohrndorf A, Christ HJ, Fritzen CP, Graw JA, Schmitt J. Journal: J Orthop Surg Res. 2018 Jul 11;13(1):176. doi: 10.1186/s13018-018-0876-0. PMID: 29996853