Fusion of the first metatarsophalangeal joint, a review of techniques and considerations

Fusion of the first metatarsophalangeal joint (MTP 1) may be a rewarding approach to many MTP 1 joint related forefoot problems. The outcome, however may be impaired by malposition, malunion or deterioration of the interphalangeal joint. To avoid this, meticulous effort must be made to achieve accurate angles, to prepare the joint surfaces and to fix the fusion in an optimal manner. We have here tried to penetrate and analyse considerations concerning these aspects and describe our choice of method, in which we used the rounded cup and cone technique for preparation, a guide-plate for positioning aid and two crossed screws for fixation. This method resulted in 21 out of 22 cases healed in an adequate position.