OBJECTIVES The purposes of this study were to examine indications, radiographic outcomes, and clinical complications for primary arthrodesis of the great toe interphalangeal (IP) joint in young patients. BACKGROUND Hallux valgus interphalangeus deformity of the great toe is uncommon in the pediatric population and often requires fusion of the IP joint. METHODS A retrospective review of patients, ages 8 to 19 years, who underwent operative fusion of the great toe IP joint, and had >1 year radiographic follow-up was performed. Medical records and radiographs were reviewed to determine indications for surgery, concomitant procedures, success of fusion, complications, and need for revision procedures or elective hardware removal. Differences between pre and postradiographic outcomes for the hallux valgus angle, IP angle, and intermetatarsal angle were analyzed. RESULTS Twenty-seven patients (31 feet) were included in the analyses. The average age at fusion surgery was 14.9 years (SD ± 2.3) with a mean follow-up visit of 35.2 months. The most common indications for fusion of the great toe IP joint were pain and deformity. Kirschner wire fixation was utilized in 7 cases, with the remaining 24 cases fixed with a single retrograde cannulated screw. Fifty-five concomitant toe and foot procedures were performed in 21 feet (68%) to address additional foot and toe deformity. Successful fusion occurred in 30 of 31 toes after the primary fusion. Patient satisfaction with the toe position and diminished pain were high (94.1%). Significant improvement was noted in the measure of the IP angle ( P < 0.001), with minimal clinical change in the hallux valgus angle ( P = 0.24) or the intermetatarsal angle ( P = 0.03). CONCLUSIONS Hallux valgus interphalangeus of the great toe was successfully managed with the fusion of the IP joint. Single screw fixation or the use of Kirschner wires led to similar outcomes. Hardware-related issues with the use of screws were the most common adverse outcome. Patients should be made aware of the possible need for hardware removal after fusion utilizing screw fixation. LEVEL OF EVIDENCE Level IV-a retrospective case series.

中文翻译：

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大脚趾指间融合术治疗年轻患者的拇趾外翻指间畸形。

目的 本研究的目的是检查年轻患者大脚趾指间 (IP) 关节初次关节融合术的适应症、影像学结果和临床并发症。背景技术大脚趾的拇外翻指间畸形在儿科人群中并不常见，并且通常需要IP关节融合。方法 对年龄 8 至 19 岁、接受大脚趾 IP 关节融合手术并进行 1 年以上影像学随访的患者进行回顾性分析。审查医疗记录和射线照片以确定手术适应症、伴随手术、融合成功、并发症以及是否需要进行翻修手术或选择性硬件移除。分析了放射学检查前后拇外翻角、IP 角和跖骨间角的结果之间的差异。结果 27 名患者（31 英尺）被纳入分析。融合手术的平均年龄为 14.9 岁 (SD ± 2.3)，平均随访时间为 35.2 个月。大脚趾IP关节融合的最常见适应症是疼痛和畸形。7例采用克氏针固定，其余24例采用单逆行空心螺钉固定。在 21 英尺 (68%) 的区域内进行了 55 例伴随的脚趾和足部手术，以解决额外的足部和脚趾畸形问题。初次融合后，31 个脚趾中有 30 个脚趾成功融合。患者对脚趾位置和疼痛减轻的满意度很高（94.1%）。IP 角测量值显着改善（P < 0.001），拇外翻角（P = 0.24）或跖骨间角（P = 0.03）临床变化最小。结论 通过 IP 关节融合成功治疗了大脚趾拇趾外翻。单螺钉固定或使用克氏针会产生类似的结果。与使用螺钉相关的硬件问题是最常见的不良后果。应让患者意识到使用螺钉固定融合后可能需要移除硬件。证据级别 IV 级——回顾性病例系列。