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It has been postulated to produce good results in the literature. Various fixation techniques offer differences in union rates, complications and functional outcomes, stirring debates about which produces the best outcomes for patients. Therefore, this review aims to synthesise and compare the outcomes of modern fixation techniques used for first metatarsophalangeal joint (FMPJ) arthrodesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The electronic database searched were PubMed, CINAHL, Cochrane Library, and Google Scholar. The critical appraisal skills programme tool for cohort study was used. The interventions consisted of screw(s), plate(s), and staple(s). Studies comprising outdated fixation techniques such as suture, metallic wire, external fixation, Rush rods or Steinmann pins were excluded. Participants were adults over 18 years, undergoing FMPJ arthrodesis in the UK. Studies with the population consisting primarily of revision cases, patients with rheumatoid arthritis or diabetes were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven UK studies included 277\u00a0feet and a 95.7% overall union rate at a mean union time of 83.5\u00a0days. Staples had the highest union rate of 98.2% at mean union time of 84\u00a0days, followed by plates (95.2%, 92\u00a0days), and finally screws (94.9%, 71\u00a0days). The overall complication incidence is 5.8%. All of the fixation techniques produced good functional outcomes postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Whilst staple techniques showed the highest union rate, plating techniques are preferable over screws or staples for better results across several outcome measures, including reduced complication incidence, stability, early ambulation, and good functional outcome. The Manchester\u2010Oxford Foot Questionnaire and EuroQol\u20105Dimensional are recommended as measurement tools to assess functional outcomes following FMPJ arthrodesis.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13047-022-00540-9","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T02:02:43Z","timestamp":1650938563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["First metatarsophalangeal joint arthrodesis\/fusion: a systematic review of modern fixation techniques"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1126-7128","authenticated-orcid":false,"given":"Yang S.","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Podiatry School of Human and Health Sciences University of Huddersfield Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Bridgen","sequence":"additional","affiliation":[{"name":"Department of Podiatry School of Human and Health Sciences University of Huddersfield Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200311000\u201000003"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.17.00032"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v12.i7.485"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757\u20101146\u20103\u201021"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102013\u2010203804"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11071"},{"key":"e_1_2_11_8_1","unstructured":"TikkanenR OsbornR MossialosE DjordjevicA WhartonGA.International Health Care System Profiles: England.https:\/\/www.commonwealthfund.org\/international\u2010health\u2010policy\u2010center\/countries\/england. 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