title: Femoral Head Allograft for First Metatarsal Phalangeal Joint Fusion Using a Reamer Technique to Limit Graft Length.
abstract: The use of interpositional bone grafting for arthrodesis of the first metatarsophalangeal joint can be a technically challenging procedure. A fresh-frozen femoral head allograft can provide an appropriate graft for lengthening and ultimate fusion. It has been well-documented in published studies that larger grafts at this site increase the risk of complications. When the joint is resected in a "square" fashion, length is actually lost from the first metatarsal head. We present a technique using a reamer applied to 1 side of the graft and the first metatarsal head in a "cup-and-cone" fashion, thereby limiting the total length of the actual graft size. This technique allows for easy positioning and lengthening, increasing the chance of graft incorporation at the fusion sites.
authors.affiliation: Chief Resident Physician, Dekalb Medical, Decatur, GA. Electronic address: mccammondpm@gmail.com.
authors.forename: Matt
authors.initials: M
authors.lastname: McCammon
authors.affiliation: Attending Physician, Dekalb Medical, Oakwood, GA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Brosky
authors.affiliation: Fellow, The Southeast Permanente Foot and Ankle Trauma and Reconstructive Surgical Fellowship, Atlanta, GA.
authors.forename: Sofie L
authors.initials: SL
authors.lastname: Pinney
mesh_terms: D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D005270:Femur Head / Q000601:surgery; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D016268:Internal Fixators; D008683:Metatarsophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D010003:Osteoarthritis / Q000150:complications / Q000503:physiopathology; D011379:Prognosis; D018570:Risk Assessment; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome
keywords: allograft; arthrodesis; bone; interpositional; surgery