{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:06:57Z","timestamp":1777615617582,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2011,12,1]],"date-time":"2011-12-01T00:00:00Z","timestamp":1322697600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:p>Myriad forms of fixation have been proposed for arthrodesis of the first metatarsal\u2013phalangeal joint (MTPJ). However, nonunion of the arthrodesis site remains a common complication. The authors performed a retrospective review of all patients undergoing arthrodesis of the first MTPJ with flexible titanium intramedullary nails alone or supplemented with static staples followed by immediate protected weight bearing. Subjects were included if they had surgery performed only by one of us; not undergone bilateral surgery in the same setting; surgery for pathology of the first MTPJ other than rheumatoid arthritis; weight-bearing preoperative radiographs; postoperative weight-bearing radiographs demonstrating presence or absence of union at the arthrodesis site; initiated weight bearing on the operative foot immediately postoperative in a protective shoe; and documentation of any complications. A total of 128 patients (148 feet) met inclusion criteria and were included. There were 110 (85.9%) females and 18 (14.1%) males with a mean age \u00b1 SD of 64 \u00b1 14.1 years. Indications included (a) 93 (62.8%) severe hallux valgus deformity, (b) 37 (25%) hallux rigidus, and (c) 18 (12.2%) failed first MTPJ surgeries. Ten different configurations where included based on the requirements needed to achieve a solid construct intraoperatively. There were a total of 9 (6.1%) complications consisting of 4 (2.7%) asymptomatic nonunions, 4 (2.7%) hardware removals, and 1 (0.7%) loss of reduction requiring revision surgery. The incidence of nonunion with flexible titanium intramedullary nails alone or supplemented with static staples followed by immediate protected weight bearing for predominantly severe hallux valgus and hallux rigidus is lower than the historic mean for most other fixation techniques. However, there is still a need for methodologically sound prospective cohort studies that focus on the use of isolated arthrodesis of the first MTPJ for purely severe hallux valgus or hallux rigidus, and comparison of the technique presented here with other modern osteosynthesis techniques.<\/jats:p>\n                  <jats:p>Levels of Evidence: Therapeutic, Level IV<\/jats:p>","DOI":"10.1177\/1938640011428512","type":"journal-article","created":{"date-parts":[[2011,12,3]],"date-time":"2011-12-03T01:01:25Z","timestamp":1322874085000},"page":"12-16","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Arthrodesis of the First Metatarsal\u2013Phalangeal Joint With Flexible, Ridged Titanium Intramedullary Nails Alone or Supplemented With Static Staples and Immediate Weight Bearing"],"prefix":"10.1177","volume":"5","author":[{"given":"Thomas S.","family":"Roukis","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Podiatry, and Sports Medicine, Gundersen Lutheran Healthcare System, La Crosse, Wisconsin (TSR)"},{"name":"Clinique Saint Charles, Lyon, France (TM, MA)"},{"name":"Drs Roukis, Meusnier, and Augoyard are consultants for MMI, Inc"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tristan","family":"Meusnier","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Podiatry, and Sports Medicine, Gundersen Lutheran Healthcare System, La Crosse, Wisconsin (TSR)"},{"name":"Clinique Saint Charles, Lyon, France (TM, MA)"},{"name":"Drs Roukis, Meusnier, and Augoyard are consultants for MMI, Inc"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Augoyard","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Podiatry, and Sports Medicine, Gundersen Lutheran Healthcare System, La Crosse, Wisconsin (TSR)"},{"name":"Clinique Saint Charles, Lyon, France (TM, MA)"},{"name":"Drs Roukis, Meusnier, and Augoyard are consultants for MMI, Inc"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,12,1]]},"reference":[{"key":"bibr1-1938640011428512","first-page":"177","volume":"29","author":"Coughlin MJ","year":"1990","journal-title":"Orthop Rev"},{"key":"bibr2-1938640011428512","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-84-6-266"},{"key":"bibr3-1938640011428512","first-page":"263","volume":"54","author":"Marks RM","year":"2005","journal-title":"Instr Course Lect"},{"key":"bibr4-1938640011428512","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2003.09.001"},{"key":"bibr5-1938640011428512","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2008.0637"},{"key":"bibr6-1938640011428512","doi-asserted-by":"publisher","DOI":"10.3928\/0147-7447-19900901-16"},{"key":"bibr7-1938640011428512","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2011.06.012"},{"key":"bibr8-1938640011428512","first-page":"41","volume":"13","author":"Maestro M","year":"1997","journal-title":"M\u00e9d Chir Pied"},{"key":"bibr9-1938640011428512","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2009.03.008"},{"key":"bibr10-1938640011428512","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2009.04.008"}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640011428512","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1938640011428512","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640011428512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:31:52Z","timestamp":1777411912000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1938640011428512"}},"subtitle":["A Consecutive Series of 148 Procedures"],"short-title":[],"issued":{"date-parts":[[2011,12,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2012,2]]}},"alternative-id":["10.1177\/1938640011428512"],"URL":"https:\/\/doi.org\/10.1177\/1938640011428512","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12,1]]}}}