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University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany
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-reported outcomes and a relatively low risk of complications ( 7 , 8 , 9 ). However, non-union after first MTPJ arthrodesis is one of the most common complications, with an incidence range of 0–24% ( 10 , 11 , 12 , 13 , 14 ). The reported incidence of non-union
Orthopaedic Surgery Working Group, Society of Junior Doctors, Athens, Greece
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University of Patras, School of Medicine, Patras, Greece
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NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK
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mobile. It is these features that account for the increased propensity of delayed union/non-union in the metaphyseal–diaphyseal junction, and additionally, the stresses exerted at the mobile metatarsal head, which are directed to the base, using the
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patients lost to follow-up and deemed non-compliant with treatment (1575 patients). The authors reported higher union rates for foot and ankle fractures compared to the overall average rate of healing for all fractures. In this study, 122/125 (98%) ankle
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approximately 15% in matched control groups of non-diabetic patients. 1 , 3 – 5 A recent large-scale study showed that diabetes mellitus (DM) had the highest odds for amputation after ankle fracture fixation, compared to any other risk factors, 6
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patients over 55 ( 6 ), open reduction internal fixation (ORIF) have not produced satisfactory outcomes in some studies. Litchfield reported a 22.6% non-union rate (7/31) ( 7 ), whilst Beauchamp et al. reported a total complication rate of 50.1% and an
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° upper limit. 7 , 8 , 11 The distal metatarsal articular angle (DMAA) is measured between the distal articular surface and the perpendicular line to the longitudinal axis of the first metatarsal. It is considered non-pathological at up to 10° in
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leading to significantly increased rates of infection and other complications as compared to non-diabetics. 11 The combination of these pathological conditions results in a significant delay in bone healing in diabetic patients, with reported union
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osteoarthritis hallux rigidus is the most common arthritic condition in the foot. Progression of great toe arthritis is associated with pain and loss of motion. Non-surgical intervention begins with shoe modifications and orthotics designed to limit MTP motion
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particular. A conservative regimen leads to a higher amount of malunions and non-unions of up to 73%, whereas open reduction and internal fixation (ORIF) provides a consolidation rate up to 100% ( 13 , 14 ). However, the complication rate after surgery in
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osteotomies. However, the majority are case series or small non-randomised studies. Interpretation is further compounded by the heterogeneity in the clinical and radiological definitions of successful graft incorporation and union. Additionally, the studies
