Arthrodesis of the Hallux Metatarsophalangeal Joint.

Abstract

Arthrodesis of the first metatarsophalangeal joint is the most reliable surgical option, with a low complication rate, for hallux rigidus from end-stage osteoarthritis. Make a medial approach, following the mid-axis of the joint. Using a cup-cone configuration provides excellent bone exposure, construct stability, and metatarsophalangeal joint congruity. Fix the toe in 5° to 10° of valgus and elevated 5 mm from the floor to achieve desired dorsiflexion. Achieve a stable construct with a crossed lag screw and a dorsal locking plate (a hybrid construct). Perform a standard soft-tissue closure. Allow weight-bearing as tolerated after two weeks and impact exercises only after bone healing has been shown on radiographs, which can take up to ten weeks. Arthrodesis of the metatarsophalangeal joint in the hallux provides good results in terms of patient satisfaction and function, as demonstrated in many studies, most of them retrospective.IndicationsContraindicationsPitfalls & Challenges.