Hallux valgus: the main risk factor for nonunion in first MTPJ fusion treated with a dorsal plate

IntroductionWe aimed to retrospectively identify risk factors for delayed / non-union for first metatarsophalangeal joint fusion.MethodsCase notes and radiograph analysis was performed for operations between April 2014 and April 2016 with at least 3 months post-operative follow up. Union was defined as bridging bone across the fusion site on AP and lateral radiographic views with no movement or pain at the MTPJ on examination. If union was not certain, CT scans were performed. All patients operations were performed/supervised by one of three consultant foot surgeons. Surgery was performed through a dorsal approach using the Anchorage compression plate. Blinded pre-operative AP radiographs were analysed for the presence of a severe hallux valgus angle equal or above 40 degrees. Measurement intra-observer reliability was acceptable (95%CI:1.6–2.3 degrees). Smoking and medical conditions associated with non-union underwent univariate analysis for significance.Results73 patients, 9 male, 64 female with a mean...