scholarly journals Five-year Outcomes of a Synthetic Cartilage Implant for the First Metatarsophalangeal Joint in Advanced Hallux Rigidus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0005
Author(s):  
Mark Glazebrook ◽  
Chris Blundell ◽  
Dishan Singh ◽  
Gwyneth de Vries ◽  
Ian Le ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Data Entry ◽  
Metatarsophalangeal Joint ◽  
Well Being ◽  
Hallux Rigidus ◽  
Implant Removal ◽  
First Metatarsophalangeal Joint ◽  
Surgical Interventions ◽  
Safety Outcomes

Category: Midfoot/Forefoot Introduction/Purpose: Hallux rigidus is the most common arthritic condition of the foot. A prospective, randomized, non-inferiority clinical trial of first metatarsophalangeal joint (MTPJ) hemiarthroplasty with a synthetic polyvinyl alcohol hydrogel implant, for moderate to severe hallux rigidus, demonstrated maintenance of MTPJ active dorsiflexion motion and excellent pain relief; additionally, the trial showed functional outcomes and safety equivalent to first MTPJ arthrodesis at 24 months (Baumhauer et al. 2016; FAI:37(5):457-469). Recognizing that many hemiarthroplasty and total toe implants have initially good results that deteriorate over time, the purpose of this study was to prospectively assess the safety and efficacy outcomes for the synthetic cartilage implant population and to determine if the excellent outcomes were maintained at >5 years. Methods: One hundred and fifty-two patients underwent implant hemiarthroplasty in the original trial; 14 underwent implant removal and conversion to fusion and 3 were lost to follow-up during the first 24 months, leaving 135 eligible for this study. One hundred patients were evaluated at 5+ years; 5 could not be reached for follow-up. Thirty are pending consent, follow-up, and/or data entry; their status will be available for inclusion at the conference presentation. Patients completed a pain visual analogue scale (VAS) and Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) scores, preoperatively and at 2, 6, 12, 26, 52, 104 and 260 weeks postoperatively. Minimal clinically important differences are: =30% difference for pain VAS, 9 points for FAAM Sports, and 8 points for FAAM ADL. Great toe active dorsiflexion, weight-bearing radiographs, secondary procedures, and safety parameters were evaluated. Results: Of 100 synthetic cartilage implant hemiarthroplasty patients available at mean 5.8 years follow-up (SD ±0.7; range: 4.4- 7.4), 5 underwent implant removal and conversion to fusion in years 2-5 (Figure 1), and 2 underwent subsequent surgical interventions during the pivotal trial and were censored, leaving 93 patients for evaluation. Pain and function outcomes observed at 5.8 years were similar to those at 2 years (Figure 1). VAS Pain and FAAM Sports Scores were maintained or improved at 5.8 years follow-up, but these differences were not clinically significant. Joint motion was maintained at 5.8 years. No evidence of avascular necrosis, device migration or fragmentation was observed upon independent radiographic review. Eighty-six percent of patients agreed their overall well-being had improved, and 92% would have the procedure again. Conclusion: Clinical and safety outcomes of patients having undergone synthetic cartilage implant hemiarthroplasty for the surgical treatment of hallux rigidus were previously demonstrated to be non-inferior to the gold standard treatment, MTPJ fusion, at 2 years. Prospectively determined outcomes for 100/135 of these implant hemiarthroplasty patients at 5.8 years are similar to those reported at 2 years. Longer-term results demonstrate that clinical and safety outcomes for synthetic cartilage implant hemiarthroplasty are durable, and that the implant remains a viable treatment option to decrease pain, improve function and maintain motion for advanced hallux rigidus.

Foot Orthotics with Morton's Extension doesn't Affects the Forces inside First Metatarsophalangeal Joint in Osteoarthritis Pathology.

2021 ◽  
Author(s):  
Ruben Sanchez-Gomez ◽  
Juan Manuel Lopez-Alcorocho ◽  
Carlos Romero-Morales ◽  
Alvaro Gomez-Carrion ◽  
Ignacio Zaragoza-García ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Weight Bearing ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Control Group ◽  
Case Group ◽  
First Metatarsophalangeal Joint ◽  
Group A ◽  
Applied Forces ◽  
Pulling Force

Abstract Study designCase-control studyBackgroundRigid Morton’s extension (ME) are a kind of orthotics that have been used as conservative treatments of hallux rigidus (HR) named osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have been studied, but not on its applied forces neither in HR subjects.ObjectivesThis study sought to understand how ME orthotics with three different thicknesses could influence the kinetic first MPJ, measured dorsally using the Jack maneuver and comparing subjects with normal first MPJ mobility versus those with HR. We aimed to clarify whether tension values were different between healthy and HR subjects.Methods Fifty-eight healthy subjects were selected, of which 30 were included in the case group according to HR criteria, and 28 were included in the control group. A digital algometer was used to assess the pulled tension values (kgf) of the first MPJ during the Jack maneuver (2-mm, 4-mm, and 8-mm ME thicknesses) versus the first MPJ in the weight-bearing resting position (WRP).ResultsThe pulled tension values were reliable (ICC > 0.963). There were no statistically significant differences between the pulled tension values for the different WRP and ME conditions in the case (p = 0.969) or control (p = 0.718) groups. ConclusionsDifferent ME thicknesses had no influence on the pulled tension applied during the simulated dorsiflexion Jack maneuver.Clinical Relevance This research aims to highlight the importance of the force effects of ME when treating hallux rigidus conservatively. Our results indicate that the tension values of the first MPJ during Jack maneuver had no significant pulling force effects on ME in healthy and hallux rigidus subjects, which suggests that its prescription can be made without danger of joint overload.

Evaluation of Metatarsal Head Resurfacing Hemiarthroplasty in the Surgical Treatment of Hallux Rigidus: A Retrospective Study and Mid- to Long-Term Follow-up

2017 ◽  
Vol 11 (1) ◽  
pp. 22-31 ◽  
Author(s):  
Musa Uğur Mermerkaya ◽  
Erkan Alkan ◽  
Mehmet Ayvaz
Keyword(s):  
Surgical Treatment ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Treatment Method ◽  
Hallux Rigidus ◽  
Retrospective Case ◽  
First Metatarsophalangeal Joint

Background. The aim of this study was to evaluate the mid- to long-term outcomes of metatarsal head resurfacing hemiarthroplasty in the surgical treatment of advanced-stage hallux rigidus. Methods. We performed a retrospective review of 57 consecutive patients (25 [43.9%] males, 32 [56.1%] females; mean age, 61.0 ± 6.4 years) who underwent first metatarsal head resurfacing hemiarthroplasty (HemiCAP) for hallux rigidus between August 2007 and September 2010. Sixty-five implantations were performed in 57 patients; 8 patients underwent bilateral procedures. All patients were clinically rated prior to surgery and at the final follow-up visit using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and first metatarsophalangeal joint range of motion (MTPJ ROM). Results. The median follow-up duration was 81 (range = 8-98) months. The median preoperative AOFAS score was 34 (range = 22-59) points, which had increased to 83 (range = 26-97) points at the final follow-up visit (P < .001). The median preoperative first MTPJ ROM was 25° (range = 15° to 40°), which had increased to 75° (range = 30° to 85°) at the final follow-up visit (P < .001). Conclusions. First MTPJ hemiarthroplasty is an effective treatment method that recovers toe function and first MTPJ ROM, and provides good mid- to long-term functional outcomes. Levels of Evidence: Level IV: Retrospective case series

scholarly journals TL 18237 - First metatarsophalangeal joint arthrodesis using a minimally invasive technique

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 112S
Author(s):  
Luiz Carlos Ribeiro Lara ◽  
Lúcio Carlos Torres ◽  
Gabriel Cervone ◽  
Juan Antonio Grajales ◽  
Fabio Lemos Rodrigues
Keyword(s):  
Minimally Invasive ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Percutaneous Technique ◽  
First Metatarsophalangeal Joint ◽  
The Mean ◽  
Larger Sample

Introduction: Metatarsophalangeal joint arthrodesis (MTPA) is a surgical technique indicated for the treatment of hallux rigidus with advanced arthrosis and for rheumatic diseases. This classic surgery is widely used and effective; however, the use of a minimally invasive technique remains mostly unknown. Objective: To present the outcome of MTPA performed using a percutaneous technique. Methods: Hallux MTPA was performed in 8 feet from 4 patients with hallux rigidus and 4 with rheumatoid arthritis, with a higher prevalence of women than men (5 vs. 3) and a mean postoperative follow-up time of 1.5 years. The outcomes were evaluated using a modified version of the American Orthopedic Foot and Ankle Society (AOFAS) questionnaire and the union time. Results: All patients who underwent surgery showed improvements in pain and arthrodesis union at approximately 8 weeks. The mean AOFAS score increased to 85 points (of a total of 90 possible points). There were no complications, such as infection, nonunion or persistent pain. Conclusion: The percutaneous technique of hallux MTPA was effective, with satisfactory outcomes, reduced surgical invasiveness, immediate walking, rapid union with “arthrodesis take” and significant improvement in pain. However, a larger sample is required to confirm the outcomes.

scholarly journals Outcomes Following Interposition Arthroplasty of the First Metatarsophalangeal Joint for the Treatment of Hallux Rigidus: A Systematic Review

2019 ◽  
Vol 4 (2) ◽  
pp. 247301141881442 ◽  
Author(s):  
Brendan R. Emmons ◽  
Dominic S. Carreira
Keyword(s):  
Systematic Review ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Cochrane Central Register ◽  
Interposition Arthroplasty ◽  
Level Of Evidence ◽  
First Metatarsophalangeal Joint ◽  
Number Of Patients ◽  
Long Term Follow Up

Background: Interposition arthroplasty of the first MTP joint has recently experienced renewed interest as a treatment for hallux rigidus. The purpose of this study was to systematically review the rapidly expanding literature on PRO following interposition arthroplasty of the first MTP joint. Methods: PubMed Central, Embase, and the Cochrane Central Register for Controlled Trials (CENTRAL) were searched. Inclusion criteria included length of time to follow-up, number of patients, outcome measure, and use of allogeneic or autogenous soft tissue or a synthetic matrix as interposition. Results: 20 studies were included in the review, comprising 498 patients and 539 feet with mean time to follow-up of 4.5 years. The most common substance used for interposition in the included studies was autogenous first MTPJ capsular tissue, a technique reported on in 12 (60.0%) of the included articles. In studies reporting preoperative and postoperative outcomes by way of a standardized outcome scoring system, mean group improvements exceed minimal clinically important differences in the majority of studies. Eighty-five percent of the studies included in this review were of Level IV quality evidence, and of this subset of studies, 70.6% were of a retrospective nature. Progression to further surgery was observed in 3.8% of toes. The most common complication reported was transfer metatarsalgia of 1 or more lesser toes, observed in up to 57.9% of patients in one study. Conclusion: Interposition arthroplasty appears to be a viable option for the treatment of moderate to severe hallux rigidus in patients looking to salvage motion through the first metatarsophalangeal joint. A wide array of autogenous, allogeneic, and synthetic implant materials have surfaced in recent years, but long-term follow-up and prospective, comparative study designs with low risk of bias are limited. Level of Evidence: Level IV, systematic review of Level III-IV studies

Silastic first metatarsophalangeal joint arthroplasty for the treatment of end-stage hallux rigidus

2020 ◽  
Vol 102-B (2) ◽  
pp. 220-226 ◽  
Author(s):  
Timothy M. Clough ◽  
Joseph Ring
Keyword(s):  
Metatarsophalangeal Joint ◽  
Visual Analogue Score ◽  
Patient Reported Outcome Measures ◽  
Hallux Rigidus ◽  
First Metatarsophalangeal Joint ◽  
Patient Reported ◽  
Silastic Implant ◽  
The Mean ◽  
End Stage

Aims Arthroplasty for end-stage hallux rigidus (HR) is controversial. Arthrodesis remains the gold standard for surgical treatment, although is not without its complications, with rates of up to 10% for nonunion, 14% for reoperation and 10% for metatarsalgia. The aim of this study was to analyze the outcome of a double-stemmed silastic implant (Wright-Medical, Memphis, Tennessee, USA) for patients with end-stage HR. Methods We conducted a retrospective review of 108 consecutive implants in 76 patients, between January 2005 and December 2016, with a minimum follow-up of two years. The mean age of the patients at the time of surgery was 61.6 years (42 to 84). There were 104 females and four males. Clinical, radiological, patient reported outcome measures (PROMS) data, a visual analogue score (VAS) for pain, and satisfaction scores were collected. Results The survivorship at a mean follow-up of 5.3 years (2.1 to 14.1) was 97.2%. The mean Manchester Oxford Foot and Ankle Questionnaire (MOXFQ) scores improved from 78.1 to 11.0, and VAS scores for pain from 7/10 to 1.3/10. The rate of satisfaction was 90.6%. Three implants (2.8%) required revision; one for infection, one-month postoperatively, and two for stem breakage at 10.4 and 13.3 years postoperatively. There was a 1.9% reoperation rate other than revision, 23.1% of patients developed a minor complication, and 21.1% of patients had non-progressive and asymptomatic cysts on radiological review. Conclusion We report a 97.2% survivorship at a mean follow-up of 5.3 years with this implant. We did not find progressive osteolysis, as has been previously reported. These results suggest that this double-stemmed silastic implant provides a predictable and reliable alternative with comparable outcomes to arthrodesis for the treatment of end-stage HR. Cite this article: Bone Joint J 2020;102-B(2):220–226.

scholarly journals Rate of Development of Hallucal Interphalangeal Degenerative Joint Disease After First Metatarsophalangeal Joint Arthrodesis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0025
Author(s):  
Christopher Hyer ◽  
Nisha Shah ◽  
Marcus Richardson
Keyword(s):  
Surgical Procedures ◽  
Weight Bearing ◽  
Subsequent Development ◽  
Metatarsophalangeal Joint ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Inclusion Criteria ◽  
First Metatarsophalangeal Joint ◽  
Post Surgery

Category: Midfoot/Forefoot Introduction/Purpose: The first metatarsophalangeal joint (MTPJ) is an integral part of the foot during the gait cycle. Arthrodesis of this joint is gold standard, especially in patients with rheumatoid arthritis. The development of IPJ arthritis after an arthrodesis of the MTPJ has been established in the literature; however, the significance of this has not. The purpose of this study was to determine the rate of IPJ degenerative joint disease (DJD) in patients who underwent first MTPJ fusion by evaluating the degree of IPJ arthritic degeneration through 2 years post-surgery and to compare radiographic parameters over time among patients with and without DJD in order to determine whether non-fusion (less than 50% fusion) or the hallucal position was associated with the subsequent development of DJD. Methods: Retrospective clinical and radiographic review of patients who had undergone a first metatarsophalangeal joint arthrodesis was performed. Inclusion criteria were adult patients 18 and older who underwent first MPJ arthrodesis between January 2012 and January 2015 with internal fixation of any type. Patients were excluded if they were under 18 years of age, underwent concomitant procedures that would affect postoperative weight bearing course, suspected or diagnosed with osteomyelitis of the foot, had prior surgical procedures of the MTPJ or IPJ joints, or concomitant hallucal IPJ arthritis or preexisting IPJ fusion. Postoperative radiographs were obtained immediately following surgery and at approximately 6 weeks, 3 months, 6 months, 12 months, and 24 months. Results: Ultimately, 103 patients met all the inclusion criteria and none of the exclusion criteria. Four of the 103 patients (3.9%) had undergone bilateral procedures, thus providing 107 surgical procedures. Demographic characteristics can be found on Table 1. The hallux abductus (HA) angle and hallux abductus interphalangeus (HAI) angle were measured preoperatively and postoperatively (Fig. 1-2). The average postoperative follow-up radiograph was taken at 22.9 weeks. The HA angle average preoperatively was 31.4 degrees, which decreased to 11.8 degrees postoperatively. The HAI angle average preoperatively measured 10.8 degrees and increased to 11.9 degrees postoperatively. No patients had symptomatic hallux IPJ postoperatively within the study period. However, 7 patients needed hardware removal and second surgery at an average of 36.3 weeks due to hardware pain and nonunion. Conclusion: Arthrodesis is often the treatment of choice for first MTPJ pathology, which is commonly arthritis or hallux valgus. We found the incidence of IPJ arthritis to be lower than the reported literature and unchanged over the postoperative period. Furthermore, no patients reported symptomatic hallux IPJ within the study period. Also, we found the HA angle had decreased in the patients postoperatively; however, there was a mixed trend with HAI increasing after first MTPJ fusion. The significance of this trend is unclear, but the increase of the HAI could possibly cause further pain and deterioration of the joint in the future.

scholarly journals Cartiva Hemiarthroplasty for the Treatment of Hallux Rigidus

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0025
Author(s):  
Tyler Hoskins ◽  
Jay Patel ◽  
David Goyette ◽  
Christopher Mazzei ◽  
Arianna L. Gianakos ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Retrospective Chart Review ◽  
Hallux Rigidus ◽  
P Value ◽  
First Metatarsophalangeal Joint ◽  
Surgical Interventions ◽  
Phone Calls ◽  
Surgical Methods

Category: Lesser Toes; Arthroscopy; Other Introduction/Purpose: Hallux rigidus, degenerative arthritis of the first metatarsophalangeal (MTP) joint, is the most common type of arthritis of the foot, affecting nearly 2.5% of the population over the age of 50. The standard of treatment is non-operative in nature followed by surgical intervention if pain is not alleviated. Currently, first metatarsal dorsal cheilectomy and proximal phalanx osteotomy remain the two most common surgical interventions. Recently, first metartasophalangeal hemiartshroplasty with synthetic cartilage implant has become more popular. This procedure involves the implantation of synthetic cartilage in order to preserve motion and maintain joint space of the first metatarsophalangeal joint. Due to the scarce amount of literature reported on this technique, the goal of this study was to examine its efficacy in patients treated for hallux rigidus. Methods: From 2017 to 2019 twenty patients underwent a synthetic cartilage implant hemiarthroplasty for the treatment of hallux rigidus. Functional outcome scores were assessed using the American Orthopaedic Foot & Ankle scoring system (AOFAS) and the Foot and Ankle Outcome Score Survey (FAOS). Outcomes, complications, and any reoperations were recorded through retrospective chart review, direct patient examination, and phone calls to patients and their families. A statistical analysis was performed using Fischer’s Exact Test. Results were deemed statistically significant if the calculated p-value was less than 0.05. Results: The mean follow up for our patient cohort was 17.16 months (range, 12 to 26). The average age was 55.61 years (range, 47 to 73). Mean pre-op AOFAS and FAOS were 56.37 and 55 respectively, compared to 91.89 and 88.84 after surgery (p-value <0.05). There were no significant complications or reoperations reported in any of the patients at the time of publication. Conclusion: The pre-op and post-op AOFAS and FAOS scores were deemed statistically significant. Synthetic cartilage implant hemiarthroplasty, although new, offers promising results and remains a viable treatment option to decrease pain, improve function, and maintain motion for advanced hallux rigidus. However, a prospective randomized controlled trial comparing the efficacy of this procedure to other surgical methods would be necessary to further evaluate and validate our findings.

Silastic Ball Spacer Arthroplasty in the Management of Hallux Valgus and Hallux Rigidus

Foot & Ankle ◽  
1989 ◽  
Vol 10 (2) ◽  
pp. 61-64 ◽  
Author(s):  
N. S. Broughton ◽  
A. Doran ◽  
B. F. Meggitt
Keyword(s):  
Hallux Valgus ◽  
Young Patients ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
New Bone Formation ◽  
Great Toe ◽  
First Metatarsophalangeal Joint ◽  
Proximal Migration ◽  
Original Concept

Sixty-two feet in 39 patients who were treated by insertion of a silastic ball spacer prosthesis into the first metatarsophalangeal joint for hallux valgus or hallux rigidus have been reviewed with a follow-up time of between 2 and 6 years. Twenty-one results (34%) were excellent, 27 (43%) were fair, 13 (21%) were poor, and one was revised. Seventeen feet (27%) had some metatarsalgia at followup. Results were disappointing in the young patients; in 19 cases of hallux valgus under the age of 45, 8 were either poor or had been revised. The original concept of the silastic ball spacer was to maintain great toe length and prevent proximal migration of the sesamoids. However 60% of these feet showed settling of the prosthesis or new bone formation around the prosthesis and 54% had more than 2 mm proximal migration of the sesamoid bones. The symptomatic results in these patients were similar to those in whom great toe length had been successfully maintained. The silastic ball spacer infrequently achieves its aims, however maintenance of hallux length does not seem to be important in the symptomatic result.

scholarly journals First metatarsophalangeal fusion with dorsal plate: clinical outcomes

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Giuseppe Restuccia ◽  
Fabio Cosseddu ◽  
Andrea del Chiaro ◽  
Matteo Ceccoli ◽  
Alessandro Lippi ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Metatarsophalangeal Joint ◽  
Wound Dehiscence ◽  
Dorsal Plate ◽  
First Metatarsophalangeal Joint ◽  
Low Profile ◽  
Significant Difference ◽  
The Stability ◽  
Dorsal Plating

Abstract Background First metatarsophalangeal joint (MTPJ) fusion is the most effective technique for the treatment of MTPJ primary arthritis, severe hallux valgus and failure of primary corrective surgery of these conditions. It can be achieved through different techniques. We evaluated the outcomes in a cohort of patients treated with dorsal plate arthrodesis. Materials and methods We treated 30 feet for 28 patients; the mean follow-up was 35 months. For each foot, we collected radiological and clinical assessment, with the visual analogue scale (VAS) for pain and the Manchester and Oxford Foot questionnaire (MOFQ). The technique consisted in a cup and cone arthrodesis with the application of a low profile dorsal plate. Patients were allowed for immediate weight bearing. Results Consolidation was achieved in all cases; in 29 cases, radiographic union was recorded within 6 months from surgery, in one case after 9 months. Comparison between the preoperative and postoperative of VAS and MOXFQ values showed a statistically significant difference (p < 0.05). Only one case developed wound dehiscence as complication. Conclusions Even if there is still a debate regarding the best system for MTPJ fusion, we believe cup and cone fusion with dorsal plating is an effective method. Moreover, the stability of the osteosynthesis obtained allows for immediate post-operative weight bearing, making patients able to return soon to their normal life. Trial registration We present a retrospective study; all patients enrolled were retrospectively registered.

First Metatarsophalangeal Joint Arthrodesis Using Memory Staples: Clinical and Functional Results

2020 ◽  
pp. 193864002092157
Author(s):  
Sudhakar Rao Challagundla ◽  
Roshin Thomas ◽  
Rupert Ferdinand ◽  
Evan Crane
Keyword(s):  
Metatarsophalangeal Joint ◽  
Functional Results ◽  
Hallux Rigidus ◽  
Union Rate ◽  
First Metatarsophalangeal Joint ◽  
Patient Satisfaction Scores ◽  
Extensor Hallucis Longus ◽  
The Mean ◽  
Ability Measure

Background. We present clinical and functional results of first metatarsophalangeal joint (MTPJ) arthrodesis using Memory staples. Methods. This retrospective observational study reviewed MTPJ arthrodesis with Memory staples from 2012 to 2016. Results. The mean age of 50 patients (55 feet) was 63 years (range 41-77 years). Forty-one feet were in women. Indication was hallux rigidus (n = 49) and hallux valgus (n = 6). The overall union rate was 98.2% (n = 54 of 55), including delayed healing in 3 (5.5%). The average time to union was 12 weeks. At a mean follow-up of 38 months (range 12-73 months), the mean Foot and Ankle Ability Measure score (47 out of 55, 86% response rate) was 87% (interquartile range 78%-100%). Complications included partial laceration of extensor hallucis longus (n = 1), wound infection (n = 4), wound-related (n = 2), lesser metatarsalgia (n = 3), cock up deformity (n = 1), and pain (n = 3). Conclusions. The high union rate, good patient satisfaction scores, and low rate of complications support our use of Memory staples. Levels of Evidence: Therapeutic, Level IV

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