COMPARISON OF 1ST MTPJ FIXATION BETWEEN HALLU-FIX PLATE AND ACE SCREWS

We present a case control comparison between two methods of fixation for 1st metatarsophalangeal (MTPJ) fusion. From 2007–2008 sixty patients were treated with either 4.0mm ACE (De Puy) screws or a Hallu-fix (Integra LifeSciences) plate fixation. We found no difference between the two groups in regard to age, ASA grade, smoking status and non-steroidal antiinflammatory use but there was a statistically significant difference in union rates. In the Hallu-fix group, nine patients went on to develop a non-union whereas one patient developed a non-union in the ACE screw fixation group, p = 0.01. Whilst there may be perceived advantages with the Hallu-fix system in regard to the accuracy of reduction, from our results we caution against it’s use, and have found a better outcome with cheaper 4.0mm ACE screws.