The impact of minimally invasive first metatarsophalangeal joint arthrodesis on intermetatarsal angle correction for moderate to severe hallux valgus deformity.

Abstract

First metatarsophalangeal joint arthrodesis is a well-established procedure for symptomatic relief of a painful, arthritic hallux abductovalgus deformity with substantial correction of the first intermetatarsal angle. Several recent studies have reported comparable union rates between open and minimally invasive techniques for first metatarsophalangeal joint arthrodesis, with hallux rigidus being the main indication. There is sparse literature on the impact of a minimally invasive approach to first metatarsophalangeal joint arthrodesis on intermetatarsal angle in the setting of hallux abductovalgus. A retrospective review was performed at our institution between January 2023 and August 2025. A total of 20 patients undergoing either a percutaneous first metatarsophalangeal joint arthrodesis (n=10) or an open approach (n=10) were included for analysis. All patients had hallux abductovalgus deformity with a preoperative intermetatarsal angle greater than 11°. In the open group, the average preoperative intermetatarsal angle was 13.41° compared to 13.47° degrees for the percutaneous group. Our results demonstrated average postoperative intermetatarsal angles of 9.62° and 8.60° for open and percutaneous approaches, respectively, with no statistically significant difference between the two. While previous literature reports high clinical fusion with good functional outcomes and low morbidity for percutaneous first metatarsophalangeal joint arthrodesis, this study specifically focuses on the intermetatarsal angle correction obtained for hallux abductovalgus through this approach. Our findings demonstrate that percutaneous first metatarsophalangeal joint arthrodesis can provide a similar correction of the intermetatarsal angle in moderate to severe hallux abductovalgus deformity comparable to traditional, open procedures.