First Metatarsophalangeal Arthrodesis for the Failed Hallux

Ahmed Khalil Attia; Keith A Heier

doi:10.1016/j.fcl.2022.07.001

First Metatarsophalangeal Arthrodesis for the Failed Hallux

Foot Ankle Clin. 2022 Dec;27(4):723-744. doi: 10.1016/j.fcl.2022.07.001.

Authors

Ahmed Khalil Attia¹, Keith A Heier²

Affiliations

¹ Orthopedic Surgery and Rehabilitation Department, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: Attia.footMD@gmail.com.
² Orthotexas, Dallas, TX, USA.

PMID: 36368794
DOI: 10.1016/j.fcl.2022.07.001

Abstract

Hallux metatarsophalangeal joint (MTPJ) arthrodesis was first described in 1894 by Clutton, who recommended ankylosing the MTPJ to treat painful hallux valgus (HV). He used ivory pegs to stabilize the MTP joint. Surgeons over the last century have modified the procedure and added indications, including hallux rigidus, rheumatoid arthritis, and revision of failed surgeries. This article addresses many common yet challenging clinical scenarios, and a few hot topics, related to hallux MTPJ arthrodesis, including matarsus primus elevatus, severe hallux valgus, avascular necrosis, and infections. The article provides a condensed evidence-based discussion on how to manage these challenges using MTPJ arthrodesis.

Keywords: Hallux avascular necrosis; Hallux infection; Hallux rigidus; Hallux valgus; Metatarsophalangeal joint arthrodesis; Metatarsus primus elevatus; Revision metatarsophalangeal arthrodesis.

Publication types

Review

MeSH terms

Arthrodesis / methods
Hallux Rigidus* / surgery
Hallux Valgus* / surgery
Hallux* / surgery
Humans
Male
Metatarsophalangeal Joint* / surgery
Treatment Outcome