First metatarsophalangeal joint arthrodesis with the Truncated Cone Reamer System

This manuscript introduces to the podiatric community the Truncated Cone Reamer (TCR) System for precise fashioning of the first metatarsal and proximal phalanx for a first metatarsophalangeal joint peg-in-hole type arthrodesis. As the name of the system suggests, the device reams out a truncated male cone at the metatarsal head and a corresponding female cone at the phalangeal base in the desired position. There is congruous cancellous bony contact at all apposing surfaces of the truncated cone for bony consolidation. The peg-in-hole intrinsically confers the arthrodesis stability. The authors present a step-by-step use of the TCR system, and a 1 year follow-up case study in which the TCR system was used as a template.