title: First metatarsophalangeal arthrodesis for severe bone loss.
abstract: Severe bone loss of the first metatarsal is a significant problem in revisional surgery of the first metatarsophalangeal joint either after failed hallux valgus surgery or failed primary arthrodesis. A short first ray leads to pathologic biomechanics of the forefoot, which is treated with interpositional bone block arthrodesis. A ball-in-socket preparation performed with cup-in-cone reamers is the preferred method for modeling of the bone block. An autologous iliac crest bone graft reveals good results by bony integration. Bone block arthrodesis represents a feasible treatment for severe bone loss, leading to good clinical results at midterm follow-up.
authors.affiliation: Foot and Ankle Center Vienna, Alserstrasse 43/8D, 1080 Vienna, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schuh
authors.forename: Hans-Joerg
authors.initials: HJ
authors.lastname: Trnka
mesh_terms: D001174:Arthrodesis / Q000379:methods*; D001862:Bone Resorption / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008683:Metatarsophalangeal Joint; D018579:Patient Selection