Efficient and Effective
Hallux Fusion

by

Jay Lieberman, DPM

Director of Residency Training

Northwest Medical Center

Margate, FL

Those who prefer joint fusion over implant arthroplasty for the treatment of advanced Hallux Limitus will make the argument that there are no long term studies demonstrating the success of joint implantation over a 20-30 year period of time.  For this reason, even the strongest advocates of implants will consider fusion procedures for younger patients.  The advent of new instrumentation for fusion surgery has actually tilted the scales away from implantation in certain circumstances.

Some patients may resist surgery that requires a life long reliance on foreign material or “artificial joints”.  Other patients are not concerned with enhancing motion; they simply want to eliminate their pain.  Often chronic lesser metatarsalgia is remedied through fusion of the 1st MPJ.

Patients with Cerebral Palsy or other neuromuscular disorders tend to have better results with joint stabilizing procedures.  See Pre and Post-op x-rays here.

Pre Op  26 year old female with CP Early approach to Fusion Surgery
using crossed K wires

The patient next via x-ray is a 36 year old male who sustained an osteochondral injury to his 1st Metatarsal Phalangeal Joint ten years prior to presentation in my office.  This injury precipitated a premature onset of advanced Hallux Limitus.  We jointly felt that he would be better suited for a fusion type procedure.


Pre Op Radiograph

1st MPJ Joint Fusion Procedure

Osteochondral Defect Loose Full Thickness Cartilaginous Defect

The photographs below demonstrate use of the Hallu®-Fix MPJ reamer set.. 

SURGICAL TECHNIQUE
as per manufacturer
Integra/New Deal 


PRODUCT INFORMATION

 The cup shape sculpts the articular surfaces for maximal contact and snug fit. 

Metatarsal Reamer

 Phalangeal Reamer

The Hallu®-Fix – S plate and the Hallu®-Fix – C plate are pre bent fixation devices used with snap off screws.  Used in concert with the reamers, the system facilitates the fusion procedure and offers reliable results.

Plates have both
10˚ lateral angulation (valgus)

and 10˚ dorsiflexion.

Snap off screws and 10˚ dorsiflexion

MPJ Arthrodesis Plate

Pre Op Radiograph

Post op film