To explore the clinical effect of the first metatarsophalangeal joint fusion with cross hollow compression screw and dorsal anatomical plate in the treatment of moderate and severe hallux valgus with osteoporosis.

From May 2017 to April 2019, 46 patients with moderate to severe hallux valgus and osteoporosis, aged 65-73 years, were collected. The fusion rate and the incidence of postoperative complications were observed. The hallux valgus angle (HVA), first and second metatarsal angle (IMA), American Orthopedic foot and ankle Association foot function score (AOFAS) and visual analogue scale (VAS) were compared before and at the last follow-up. Preoperative and final follow-up were compared by t test.

Forty-six patients were followed up for six to 22 months by outpatient follow-up. Forty-six cases of moderate and severe hallux valgus with osteoporosis all achieved clinical and imaging fusion of the first metatarsophalangeal joint, all achieved the purpose of early weight-bearing activities. At the last follow-up, it was found that all the incisions healed in the first stage, and no related complications occurred. Preoperative HVA was (41.8±7.6)° and postoperative HVA was (15.6±1.6)° respectively; preoperative IMA was (18.3±1.9)° and postoperative IMA was (9.6±1.3)° respectively; preoperative AOFAS was (49.7±4.7), postoperative AOFAS was (81.6±2.9) respectively; preoperative VAS was (8.9±0.9) and postoperative was (1.7±1.1). The differences of the two groups were statistically significant (t=23.75, 27.28, -35.94, 36.78, all P<0.05).

For patients with moderate and severe hallux valgus and osteoporosis, the first metatarsophalangeal joint fusion with cross hollow compression screw combined with the anatomical plate on the back is satisfactory, the fusion rate is high and the recovery is fast, which is worth clinical promotion.