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Arthrodesis of the Hallux Metatarsophalangeal Joint
Emilio Wagner1, Pablo Wagner1, Cristian Ortiz1
1Clíinica Alemana de Santiago, Av. Vitacura 5951, Vitacura, Santiago, Chile 7650568. E-mail address for E. Wagner: ewagner@alemana.cl. E-mail address for P. Wagner: pwagner@alemana.cl. E-mail address for C. Ortiz: cortiz@alemana.cl.
Introduction:
Arthrodesis of the first metatarsophalangeal joint is the most reliable surgical option, with a low complication rate, for hallux rigidus from end-stage osteoarthritis.
Step 1 Surgical Approach:
Make a medial approach, following the mid-axis of the joint.
Step 2 Joint Preparation:
Using a cup-cone configuration provides excellent bone exposure, construct stability, and metatarsophalangeal joint congruity.
Step 3 Positioning Of Arthrodesis:
Fix the toe in 5° to 10° of valgus and elevated 5 mm from the floor to achieve desired dorsiflexion.
Step 4 Application Of Implants:
Achieve a stable construct with a crossed lag screw and a dorsal locking plate (a hybrid construct).
Step 5 Closure:
Perform a standard soft-tissue closure.
Step 6 Postoperative Care:
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.
Results:
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.
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