Evidence map›Paper›PMID 36959744›Full record

ArticleFoot & ankle international2023

Factors Associated With Nonunion in Arthrodesis of the First Metatarsophalangeal Joint: A Multicenter Retrospective Cohort Study.

Wout Füssenich, Gesine H Seeber, Tom M van Raaij, Christiaan P van Lingen, Rutger G Zuurmond, Martin Stevens, Matthijs P Somford

Open access · greenAbstract readMulticenter StudyComment
PubMed Full text at PMC Publisher
In one paragraph

Article in Foot & ankle international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 2 countries.

Wout FüssenichDepartment of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.ORCID 0000-0001-9097-1051
Gesine H SeeberDepartment of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.ORCID 0000-0003-3343-9151
Tom M van RaaijDepartment of Orthopaedic Surgery, Martini Hospital, Groningen, the Netherlands.
Christiaan P van LingenDepartment of Orthopaedic Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
Rutger G ZuurmondDepartment of Orthopaedic Surgery, Isala, Zwolle, the Netherlands.
Martin StevensDepartment of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Matthijs P SomfordDepartment of Orthopaedic Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
University Medical Center Groningen · NLCarl von Ossietzky Universität Oldenburg · DEIsala · NLMartini Ziekenhuis · NLMedisch Spectrum Twente · NLRijnstate Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundArthrodesis of the first metatarsophalangeal joint is the current treatment of choice for symptomatic advanced hallux rigidus and moderate-to-severe hallux valgus. There are different methods to perform arthrodesis, yet no consensus on the best approach. Therefore, this study aimed to determine the effects of preoperative and postoperative hallux valgus angle (HVA), joint preparation and fixation technique, and postoperative immobilization on the incidence of nonunion.

methodsA retrospective multicenter cohort study was performed that included 794 patients. Univariate and multiple logistic regression was conducted to determine associations between joint preparation, fixation techniques, postoperative immobilization, weightbearing, and pre- and postoperative HVA with nonunion.

resultsNonunion incidence was 15.2%, with 11.1% symptomatic and revised. Joint preparation using hand instruments (OR 3.75, CI 1.90-7.42) and convex/concave reamers (OR 2.80, CI 1.52-5.16) were associated with greater odds of a nonunion compared to planar cuts. Joint fixation with crossed screws was associated with greater odds of nonunion (OR 2.00, CI 1.11-3.42), as was greater preoperative HVA (OR 1.02, CI 1.00-1.03). However, the latter effect disappeared after inclusion of postoperative HVA in the model, with a small association identified between residual postoperative HVA and nonunion (OR 1.04, CI 1.01-1.08). Similarly, we found an association between odds of nonunion and higher body weight (OR 1.02, CI 1.01-1.04) but not of body mass index.

conclusionBased on our results, first metatarsophalangeal joint arthrodesis with planar cuts and fixation with a plate and interfragmentary screw is associated with the lowest odds of resulting in a nonunion. Higher body weight and greater preoperative HVA were associated with slight increase in rates of nonunion. It is crucial to properly correct the hallux valgus deformity during surgery. LEVEL OF EVIDENCE: Level III, retrospective case control study.

Indexed as

BunionHallux RigidusHallux ValgusMetatarsophalangeal JointArthrodesisBody WeightCase-Control StudiesCohort StudiesHumansRadiographyRetrospective StudiesTreatment Outcomearthrodesisfirst metatarsophalangeal jointfusionhallux rigidushallux valgus

Identifiers

PMID36959744
PMCPMC10248293
OpenAlexW4360809403

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.