CASE REPORT


Percutaneous First Metatarsophalangeal Joint Fusion



Thomas Bauer*
Department of Orthopedic Surgery, Ambroise Paré University Hospital, West Paris University, 9 avenue Charles de Gaulle, 92100 Boulogne Billancourt, France


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© 2017 Thomas Bauer.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Orthopedic Surgery, Ambroise Paré University Hospital, West Paris University, 9 avenue Charles de Gaulle, 92100 Boulogne Billancourt, France; Tel: 0033149095575; E-mail: thomas.bauer@aphp.fr


Abstract

The first metatarsophalangeal (MTP1) joint fusion is a very useful procedure in forefoot surgery and is still the gold standard for the treatment of severe and painful hallux rigidus. Normal walking and running are possible after MTP1 fusion, the first ray mobility being essentially in the interphalangeal (IP) joint with a compensatory hypermobility in dorsal flexion. Percutaneous MTP1 fusion is a simple procedure providing comparable results to fusions performed with open techniques. Postoperative cares are simplified with an immediate full weight bearing on rigid flat shoes and quick return to normal walking. Bone preparation is an important step and requires an experience in percutaneous forefoot surgery. Arthrodesis positioning and fixation with this percutaneous procedure are simple with possibility of clinical and radiological control. The indications for percutaneous MTP1 fusion are very large and only severe bone loss or osteoporosis represent the limits for this technique.

Keywords: Hallux rigidus, Percutaneous surgery, Metatarsophalangeal fusion.