Metatarsophalangeal Joint Fusion: Why and How?

First metatarsophalangeal (MTP) joint fusion aims at elimination of pain resulting from end-stage arthritis and obtaining a stable, plantigrade first toe. Associated deformities are corrected and greater defects are filled with interposition autograft or allograft. Fusion is generally obtained with screws, staples, and/or low-profile plates. Complications include infection, osteonecrosis, implant protrusion or failure, nonunion, and malunion, the latter 2 each occurring in approximately 6% of cases. The medium-term results of first MTP joint fusion indicate mostly good functional results with success rates of approximately 90%.