Modification of the Keller operation for increased functional capacity

A technique for stabilization of the metatarsophalangeal joint maintaining propulsive power of the hallux and prevention of transfer lesions has been described. It utilizes the flexor hallucis longus tendon to maintain the integrity of the biomechanics of the first metatarsophalangeal joint while obviating the need for an interphalangeal joint fusion to prevent hallux flexus. The procedure is an adjunct to the medial and dorsal exostectomy, corrects for proximal and distal articular set angles, and provides for a rapid recovery of function of the metatarsophalangeal joint.