Published online Jul 18, 2021. doi: 10.5312/wjo.v12.i7.485
Peer-review started: February 14, 2021
First decision: April 6, 2021
Revised: April 18, 2021
Accepted: July 12, 2021
Article in press: July 12, 2021
Published online: July 18, 2021
Arthrodesis of the first metatarsophalangeal (MTP) joint has been established as the “gold standard” for the treatment of several first ray disorders, due to its perceived efficacy and the consistently reported good results in the literature. Arthrodesis is a commonly performed procedure for the treatment of end stage arthritis, rheumatoid arthritis with severe deformity, selected cases of severe hallux valgus (with or without signs of degenerative joint disease), as well as a salvage procedure after failed previous operation of the first ray. The goals of a successful 1st MTP arthrodesis are pain alleviation and deformity correction in order to restore a comfortable gait pattern and to improve shoe wear. Several techniques have been reported with several proposals regarding the preparation of the articular surfaces and the method of definitive fixation. As with any given surgical procedure, various complications may occur after arthrodesis of the 1st MTP joint, namely delayed union, nonunion, malunion, irritating hardware, etc.
Core Tip: Disorders of the first ray are quite common in foot and ankle surgery, as multiple pathologies can lead to degeneration and may cause stiffness to the first metatarsophalangeal (MTP) joint. If non-operative treatment fails, arthrodesis of the first MTP joint is a well-established surgical option which has demonstrated very satisfactory results. Herein, we examine the various indications for this procedure, and the different surgical techniques, regarding joint preparation and fixation constructs, that we have at our disposal in order to obtain optimum results.