First metatarsocuneiform arthrodesis: technical considerations and technique modification.

Abstract

Triplane malalignment of the first ray is frequently associated with instability and suboptimal spatial positioning at the first metatarsocuneiform joint (MCJ). The first metatarsocuneiform arthrodesis provides an effective means of addressing hypermobility in association with multiplanar first metatarsal malalignment. The first MCJ has a characteristic concave-convex surface topography that can allow the first metatarsal to translate within the transverse and sagittal planes. A method of "anatomical arthrodesis" of the first MCJ is described that utilizes the joint's unique topography to assist in the process of repositioning the first metatarsal. A step-by-step description of the procedure is provided with emphasis placed on identifying and highlighting unique areas of difficulty.