Researchers looked at 58 patients who had surgery to fuse their big toe joint to treat arthritis and a common foot deformity called bunions. They wanted to know if the angle of the bones before surgery affected how well the surgery worked. The good news: the surgery was successful in all 58 patients, regardless of how severe their foot deformity was. The bones healed at about the same speed in everyone, and the special metal plate used to hold the bones together worked reliably. This suggests doctors can confidently use this surgical technique on patients with different levels of foot deformity.

The Quick Take

  • What they studied: Whether the angle of foot bones before surgery affects how well big toe joint fusion surgery heals and how long healing takes
  • Who participated: 58 patients who had big toe joint surgery between 2010 and 2020 at one hospital’s foot and ankle surgery program. Patients were grouped by how severe their foot deformity was before surgery.
  • Key finding: All 58 patients had successful bone fusion (100% success rate), and healing time was similar across all groups regardless of how severe their foot deformity was before surgery. There were no cases of bones not healing or metal hardware failing.
  • What it means for you: If you need big toe joint surgery for arthritis or bunions, this surgical technique appears to work well regardless of how severe your foot deformity is. However, this is one study from one hospital, so talk with your doctor about your specific situation.

The Research Details

This was a retrospective study, meaning researchers looked back at medical records from patients who had already had surgery between 2010 and 2020. They divided the 58 patients into three groups based on how severe their foot bone angle was before surgery: mild, moderate, and severe. All patients had the same type of surgery using a metal plate and screw to hold the bones together while they healed.

The researchers measured how well the bones healed using a scoring system called FUSET (Foot Union Scoring Evaluation Tool) at regular check-ups after surgery. They also looked at X-rays to see when the bones completely fused together. They excluded patients who had previous foot surgery, used different hardware, or had revision surgeries, to make sure they were comparing similar cases.

Understanding whether bone angle affects surgery success helps doctors predict outcomes and choose the best surgical technique. If the angle doesn’t matter, it means this particular surgical method is reliable for a wider range of patients. This type of study is important because it shows real-world results from actual patients rather than just laboratory tests.

This study has some strengths: all patients had the same surgery technique, they were followed at regular intervals, and the success rate was very high (100%). However, it’s a single-center study from one hospital, so results might differ elsewhere. The sample size of 58 is moderate—larger studies would provide more confidence. There’s no comparison group that didn’t have surgery, so we can’t say how much better surgery is than other treatments.

What the Results Show

The most important finding was that 100% of patients achieved successful bone fusion across all three groups, regardless of how severe their foot deformity was before surgery. This means every single patient’s bones healed together properly.

The time it took for bones to completely heal was similar in all groups. Patients with mild deformity, moderate deformity, and severe deformity all healed at roughly the same pace. The FUSET scores—which measure healing progress—showed no meaningful differences between groups at any point during follow-up.

There were no cases of nonunion (bones not healing together) and no hardware failures (the metal plate and screw didn’t break or loosen). This is important because it shows the surgical technique is very reliable.

The researchers also looked at whether other factors affected healing, including smoking, diabetes, and vitamin D supplements. None of these factors appeared to significantly impact how fast the bones healed. This suggests that the surgical technique itself is robust enough to work well even in patients with these conditions.

Previous research has shown that big toe joint fusion is generally a reliable surgery for treating arthritis and bunions. This study adds to that knowledge by showing that the specific angle of foot bones before surgery doesn’t seem to affect success rates with this particular surgical technique. This is reassuring because it means doctors don’t need to worry as much about bone angle when choosing this procedure.

This study looked back at past medical records rather than following new patients forward, which can introduce errors. All patients came from one hospital, so results might be different at other hospitals with different surgeons or techniques. The study didn’t include a control group of patients who didn’t have surgery, so we can’t directly compare surgery to other treatments. The sample size of 58 is moderate—a larger study would provide stronger evidence. We don’t know about long-term outcomes beyond the healing phase, such as pain relief or function years later.

The Bottom Line

If you have arthritis or severe bunions affecting your big toe joint, this surgical technique appears to be a reliable option with high success rates (Confidence: Moderate to High). The surgery works well regardless of how severe your foot deformity is. However, discuss with your foot and ankle surgeon whether this procedure is right for your specific situation, as individual factors matter.

This research is most relevant for people considering big toe joint fusion surgery for arthritis or bunions. It’s also useful for foot and ankle surgeons choosing surgical techniques. People with mild foot deformity should know surgery can still work well for them. However, this study doesn’t address other treatment options like physical therapy or medications, so discuss all options with your doctor.

Based on this study, most patients achieved complete bone fusion within a similar timeframe across all groups, though the exact timeline isn’t specified in the abstract. Typically, bone fusion takes several weeks to months. Full functional recovery and pain relief may take longer. Ask your surgeon for a specific timeline based on your situation.

Want to Apply This Research?

  • If you have this surgery, track your pain level (0-10 scale) and ability to walk/bear weight weekly for the first 3 months, then monthly for up to a year. Note any swelling, redness, or drainage from the surgical site.
  • Follow your surgeon’s weight-bearing restrictions carefully during early healing. Use the app to set reminders for physical therapy exercises and medication if prescribed. Log any activities that cause increased pain or swelling to identify your healing limits.
  • Create a long-term tracking log for pain levels, walking distance, and activity tolerance at 3, 6, and 12 months post-surgery. Compare these metrics to your baseline to measure improvement. Share this data with your surgeon at follow-up appointments.

This research describes outcomes from one hospital’s surgical program and should not replace personalized medical advice from your doctor. Individual results vary based on many factors including overall health, age, and surgeon experience. Before having any surgery, discuss risks, benefits, and alternatives with a qualified foot and ankle surgeon. This information is educational and not a substitute for professional medical diagnosis or treatment.