J Korean Foot Ankle Soc.  2017 Mar;21(1):39-42. 10.14193/jkfas.2017.21.1.39.

Treatment of Failed Arthrodesis of First Metatarsophalangeal Joint with Tensor Fascia Lata Interposition Arthroplasty: A Case Report

• Sim J
• Hyun Y
• Park J
• Kang S
• Kwon H
• Kim G

• KMID: 2371973
• DOI: http://doi.org/10.14193/jkfas.2017.21.1.39

Abstract

Surgical treatments for arthritis in the first metatarsophalangeal joint include arthrodesis, interposition arthroplasty using silicone or meniscus cartilage, and rarely arthroplasty. Although arthrodesis was performed successfully, pain can persist if the angle of fusion was inappropriate. Interposition arthroplasty can be tried for the treatment of persisting pain after the arthrodesis. Interposition arthroplasty using tensor fascia lata is known that has low risk of adhesions and easy to harvest. Compared to autologous grafts, grafting rates is high and low risk of rejection additionally. Herein, we report a successfully managed arthritis with severe pain with interposition arthroplasty using tensor fascia lata after a failed metatarsophalangeal joint arthrodesis.

Keyword

Arthrodesis; Arthroplasty; Fascia lata; Metatarsophalangeal joint

MeSH Terms

Arthritis
Arthrodesis*
Arthroplasty*
Cartilage
Fascia Lata*
Fascia*
Metatarsophalangeal Joint*
Silicon
Silicones
Transplants
Silicon
Silicones

Figure

• 

  Figure 1 (A) Anteroposterior view of preoperative plain radiograph with standing demonstrates metatarsophalangeal angle (MPA) was 23°. (B) Lateral view of preoperative plain radiograph with standing demonstrates MPA was 15°. (C, D) Axial view of preoperative computed tomography (CT), sagittal view of preoperative CT shows union of first metatarsophalangeal joint.

• 

  Figure 2 (A, B) Osteotomy was made from distal part of first metatarsophalangeal joint and proximal part of first metatarsophalangeal joint in dorsal side. (C) Operative finding of successful osteotomy of first metatarsophalangeal joint.

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  Figure 3 (A) Tensor fascia lata was harvested from lateral side of ipsilateral thigh. (B) The harvested tensor fascia lata. (C) The harvested tensor fascia lata folded in triplicate.

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  Figure 4 The harvested tensor fascia lata was inserted to first metatarsophalangeal joint and sutured with medial and lateral collateral ligaments.

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  Figure 5 Postoperative plain radiograph with standing at postoperative 3 months. (A) Anteriorposterior view demonstrates metatarsophalangeal angle (MPA) was 0°. (B) Lateral view demonstrates MPA was 25°.

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