Modern Approaches to Hallux IP Fusions — Better or Not?

Words to remember: "A simple operation that is not always so."

What’s the Claim?

The largest case series we’ve seen on the topic of interphalangeal joint arthrodesis of the hallux found:

  • Nonunion occurred in 26% of patients
  • Reoperations occurred in 21%

We’re leery of two other claims made, though. The authors wrote that none of the approaches used — one screw, several screws, screws + “other” fixation, or non-screw fixation alone — seemed better than any other, and that smoking wasn’t associated with nonunion. The study was severely underpowered on both of those claims. The claim about smoking, in particular, is unlikely to be true, as it flies in the face of evidence at every level, from rats to RCTs.

The cautionary message of this study, however — that this operation bites back — is absolutely true.

How’s It Stack Up?