1st MTP Arthrodesis 28750

 
CPT Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:1st MTP fusion, metatarsal-phalangeal fusion

 1st MTP Arthrodesis CPT

  • 28750 Arthrodesis, great toe, MTP joint 

1st MTP Arthrodesis Indications

  • Grade 4 hallux rigidus

 1st MTP Arthrodesis Contraindications

  •  

1st MTP Arthrodesis Alternatives

  • Cheilectomy

1st MTP Arthrodesis Pre-op Planning

  • A

1st MTP Arthrodesis Technique

  • regional anesthesia, tourniquet.  
  • 4-5cm dorsal longitudinal incision centered over MTP joint.  
  • Incise capsule medial to EHL.  
  • Joint Debridement.  
  • Prox phalanx plantar flexed, 0.62mm K-wire driven proximally into center of MT head.  
  • Cannulated cylindrical reamer creates cylindrical MT.  Canulated reamer(Howmedica) creates convex cancellous MT head.  
  • 0.62mm k-wire center in base of PP.  Convex phalangeal reamers create matching surface.  
  • Hallux placed in neutral rotation, 15 valgus, 20 dorsiflexion.  
  • 6-hole vitalium mini-compression plate and lag screw.  
  • Irrigate.  Capsule repair.  Closure

1st MTP Arthrodesis Complications

1st MTP Arthrodesis Follow-up care

  • Post-op: WBAT in stiff-soled shoe on lateral aspect and heel until radiographic fusion. 3 months for maximal improvement.

1st MTP Arthrodesis Outcomes

  • Arthrodesis=  87% Excellent, 13% Good, O%fair/poor subjective patient result.

1st MTP Arthrodesis Review References

  • Goucher NR, Foot Ankle Int 2006;27:869 

 

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