Objective First MTP joint fusion is a reliable procedure for advanced arthritis for the first MTP joint. There are many techniques described. The purpose of our study is to report clinical, radiological, functional outcomes and complications of first metatarsophalangeal joint fusion with hand preparation of the joint and fixation with two orthogonal locking plates without a compression screw. Methods 32 feet in 26 consecutive patients under went first metatarsophalangeal joint fusion with above technique. There were 23 women and 3 men. Mean age was 64 years and mean follow-up was 49 months. 21 patients had osteoarthritis, 10 had rheumatoid arthritis and one had psoriatic arthritis. Clinical, radiological, American Orthopaedic Foot and Ankle Score and Foot and Ankle Disability Index clinical rating scales were used for evaluation. Results Fusion was achieved in 27 feet. The incidence of radiological non-union was 15.7%. Mean AOFAS score improved from 37.1 to 80.7 (p < 0.0001) and mean FADI score improved from 40.3 to 86.9 postoperatively (p < 0.0001). Two patients with osteoarthritis and three with Rheumatoid arthritis did not unite. Four of these patients were managing hence revision surgery was not carried out but had low AOFAS and FADI scores. One patient with symptomatic non-union declined further surgery. One patient needed plate removal for a low grade infection and reoperation rate was 3.1%. Conclusions In our experience, first metatarsophalangeal joint arthrodesis using two orthogonal two hole plates without a compression screw is associated with a higher non-union rate in our cohort hence we do not recommend this technique. Level of evidence Level IV, therapeutic study. ER -

Ankylosing spondylitis is a global health problem. There are continuous innovations in terms of etiopathogenesis, diagnosis, and treatment. Here, the top 100 most cited articles on ankylosing spondylitis during the last three decades are analyzed. On April 6, 2020, the Web of Science was screened from 1984 to 2020 using the terms ankylosing spondylitis; the top 100 most cited articles were identified. For bibliometric analysis, the name of the article, year of publication, author information, number of citations, name of the publishing journal, H-index, impact factor, countries of the authors, types of articles, and funding sources were recorded. The Altmetric attention was recorded using a program that automatically calculates the score. The total number of citations of the articles in the list ranged from 176 to 3700. Arthritis and Rheumatism (n=31) and Annals of the Rheumatic Diseases (n=27) were the two leading journals in which the majority of the articles were published. Germany produced most of the articles; Braun J was the most cited author. Randomized controlled clinical trials were found to constitute most of the articles (n=35). According to the citation number, studies evaluating classification criteria and disease activity indices and, according to the Altmetric Attention Score, studies addressing the prevalence and biological agents were prominent. We present a perspective on the extent to which the most cited articles on ankylosing spondylitis draw interest in the scientific community and on social media platforms.