Interest of a compression screw for the arthrodesis of the first metatarsophalangeal joint of the foot: comparative study

Objective : The purpose was to determine whether or not an additional compression screw to an arthrodesis of the first metatarsophalangeal joint (MTP1) by plate conferred any clinical and radiological benefits for the patient. Methods : 105 cases (95 patients) were prospectively enrolled and analysed in two groups: PLATE-only with 2 small plates fixation (n=51) and PLATE+compSCREW with an additional compression screw fixation (n=54). Both groups were followed up over 4-years and were compared using the AOFAS score and a radiologic assessment to determine the fusion rate. Results : PLATE-only reported 6 failures: 2 cases of clinical mobilisation of the joint and 4 cases of painless fibrous fusion. In the PLATE+compSCREW group, there were 3 cases of painless fibrous fusion. When considering the fusion rate, there was a significant statistical difference between the two groups. Conclusion : The use of an additional compression screw reduced the time to joint fusion and decreased the failure rate at last follow-up.