First metatarsophalangeal joint arthrodesis for severe hallux valgus deformity_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHU Yuan ,  XU Xiangyang

Department of Orthopedics, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, P. R. China;

Corresponding author：

XU Xiangyang, Email: xu664531@hotmail.com

Keywords：

First metatarsophalangeal joint; arthrodesis; hallux valgus; surgical treatment

DOI：

10.7507/1002-1892.202506114

Video：

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First metatarsophalangeal joint arthrodesis, as a corrective measure for severe hallux valgus deformity, has a long history and remains in use today. Indications for the first metatarsophalangeal joint arthrodesis include severe hallux valgus deformity, recurrent hallux valgus, hallux deformity in rheumatoid arthritis, severe hallux rigidus, joint infection, primary or secondary osteoarthritis, hallux valgus deformity due to neuromuscular disorders, and severe gouty arthritis. Innovative research continues to emerge in biomechanics and materials science related to the first metatarsophalangeal joint arthrodesis. Surgical fixation options are diverse and evolving, encompassing traditional screws and plates alongside novel intramedullary fixation systems and shape-memory alloy implants. Biomechanical studies, gait analysis research, and clinical trials consistently demonstrate minimal postoperative impact on gait and no significant impairment of functional mobility. When performed with proper technique, complications are rare. The first metatarsophalangeal joint arthrodesis is an effective and reliable method for treating severe hallux valgus deformity.

Citation： ZHU Yuan, XU Xiangyang. First metatarsophalangeal joint arthrodesis for severe hallux valgus deformity. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(10): 1232-1239. doi: 10.7507/1002-1892.202506114 Copy

1.	Clutton HH. The treatment of hallux valgus. St Thomas Hosp Rep, 1892-1893, 22: 1-12.
2.	Attia AK, Heier KA. First metatarsophalangeal arthrodesis for the failed hallux. Foot Ankle Clin, 2022, 27(4): 723-744.
3.	Coughlin MJ. Hallux valgus. J Bone Joint Surg (Am), 1996, 78(6): 932-966.
4.	Belfiore S, Vaggi S, Vitali F, et al. Rigid iatrogenic hallux varus: a decades’ worth experience with arthrodesis of the metatarsophalangeal joint. Int Orthop, 2024, 48(11): 2923-2929.
5.	Anastasio AT, Shaffrey I, Easley ME. Surgical management of failed first metatarsophalangeal joint arthroplasty. Foot Ankle Clin, 2024, 29(3): 541-556.
6.	de Bot RTAL, Veldman HD, Eurlings R, et al. Metallic hemiarthroplasty or arthrodesis of the first metatarsophalangeal joint as treatment for hallux rigidus: A systematic review and meta-analysis. Foot Ankle Surg, 2022, 28(2): 139-152.
7.	LaCoste KL, Andrews NA, Ray J, et al. First metatarsophalangeal joint arthrodesis: a narrative review of fixation constructs and their evolution. Cureus, 2021, 13(4): e14458. doi: 10.7759/cureus.14458.
8.	Prat D, Sourugeon Y, Haghverdian BA, et al. “In situ” joint preparation technique for first metatarsophalangeal arthrodesis: a retrospective comparative review of 388 cases. J Foot Ankle Surg, 2023, 62(5): 855-861.
9.	Saltzman CL, Anderson RB, Coughlin MJ. Mann’s surgery of the foot and ankle. 9th ed. 2013: 269.
10.	Bayomy AF, Aubin PM, Sangeorzan BJ, et al. Arthrodesis of the first metatarsophalangeal joint: a robotic cadaver study of the dorsiflexion angle. J Bone Joint Surg (Am), 2010, 92(8): 1754-1764.
11.	Strony JT, Rascoe AS, Marcus RE. Validation of the artificial floor technique in first metatarsophalangeal joint arthrodesis. Clin Orthop Relat Res, 2022, 480(10): 2002-2009.
12.	Kang YS, Bridgen A. First metatarsophalangeal joint arthrodesis/fusion: a systematic review of modern fixation techniques. J Foot Ankle Res, 2022, 15(1): 30. doi: 10.1186/s13047-022-00540-9.
13.	Balu AR, Baumann AN, Tsang T, et al. Evaluating the biomechanical integrity of various constructs utilized for first metatarsophalangeal joint arthrodesis: a systematic review. Materials (Basel), 2023, 16(19): 6562. doi: 10.3390/ma16196562.
14.	Haimes MA, Roberts MS, Bougioukas L, et al. Analysis of the costs and complications of first metatarsophalangeal joint arthrodesis comparing locked and non-locked plate fixation constructs. J Am Acad Orthop Surg, 2023, 31(21): e1012-e1020.
15.	Challagundla SR, Thomas R, Ferdinand R, et al. First metatarsophalangeal joint arthrodesis using memory staples: clinical and functional results. Foot Ankle Spec, 2021, 14(5): 410-414.
16.	Romere CM, Sidrak JP, Hollenbeck JFM, et al. Biomechanical comparison between fixation techniques for first-metatarsophalangeal joint arthrodesis. Foot Ankle Int, 2025, 46(8): 895-902.
17.	Tytgat HE, Wuite S, Matricali GA. Arthrodesis of the first metatarsophalangeal joint using an intraosseous fixation device. Acta Orthop Belg, 2022, 88(1): 135-142.
18.	Kuik L, Łuczkiewicz P. Safety and efficacy of medial plate in first metatarsophalangeal joint arthrodesis. Ortop Traumatol Rehabil, 2021, 23(3): 205-212.
19.	Daszkiewicz K, Rucka M, Czuraj K, et al. Effect of lag screw on stability of first metatarsophalangeal joint arthrodesis with medial plate. Peer J, 2024, 12: e16901. doi: 10.7717/peerj.16901.
20.	Mann RA, Katcherian DA. Relationship of metatarsophalangeal joint fusion on the intermetatarsal angle. Foot Ankle, 1989, 10(1): 8-11.
21.	Pydah SK, Toh EM, Sirikonda SP, et al. Intermetatarsal angular change following fusion of the first metatarsophalangeal joint. Foot Ankle Int, 2009, 30(5): 415-418.
22.	Dayton P, Feilmeier M, Hunziker B, et al. Reduction of the intermetatarsal angle after first metatarsal phalangeal joint arthrodesis: a systematic review. J Foot Ankle Surg, 2014, 53(5): 620-623.
23.	Dusch T, Guareschi A, Moore A, et al. Changes in radiographic alignment following metatarsophalangeal fusion, distal metatarsal osteotomy, and lapidus. Foot Ankle Spec, 2025, 18(5): 525-534.
24.	Doty J, Coughlin M, Hirose C, et al. Hallux metatarsophalangeal joint arthrodesis with a hybrid locking plate and a plantar neutralization screw: a prospective study. Foot Ankle Int, 2013, 34(11): 1535-1540.
25.	von Deimling C, Tondelli T, Brunner S, et al. Achieving high union rates after first metatarsophalangeal joint arthrodesis: Radiographic outcomes and technical pitfalls. World J Orthop, 2023, 14(6): 436-442.
26.	DeFrino PF, Brodsky JW, Pollo FE, et al. First metatarsophalangeal arthrodesis: a clinical, pedobarographic and gait analysis study. Foot Ankle Int, 2002, 23(6): 496-502.
27.	van Doeselaar DJ, Heesterbeek PJ, Louwerens JW, et al. Foot function after fusion of the first metatarsophalangeal joint. Foot Ankle Int, 2010, 31(8): 670-675.
28.	Poggio D, de Retana PF, Borda D, et al. Analysis of the clinical score progressions during the first year after first MTPJ fusion. Foot Ankle Int, 2010, 31(7): 578-583.
29.	Roth W, Hoch C, Gross CE, et al. First metatarsophalangeal arthrodesis outcomes for hallux rigidus versus hallux valgus. Foot Ankle Surg, 2023, 29(1): 50-55.
30.	El Masry S, Boden AL, DiGiovanni GM, et al. A comparison of PROMIS scores of metatarsophalangeal joint arthrodesis and polyvinyl alcohol hydrogel implant hemiarthroplasty for hallux rigidus. JB JS Open Access, 2024, 9(3): e23.00158. doi: 10.2106/JBJS.OA.23.00158.
31.	D’sa P, Vaidhyanathaswamy S, Teoh KH, et al. The ability to wear heeled footwear following first metatarsophalangeal joint fusion. Foot Ankle Surg, 2022, 28(4): 510-513.
32.	Webb AR, Manz WJ, Fuqua A, et al. Effect of obesity on patient-perceived outcomes after first metatarsophalangeal joint arthrodesis. Foot Ankle Spec, 2024, 17(1): 58-66.
33.	Baumann AN, Walley KC, Kermanshahi N, et al. Return to sport after first metatarsophalangeal arthrodesis: a systematic review. Foot Ankle Int, 2023, 44(12): 1319-1327.
34.	Dayton M, Dayton P, Togher CJ, et al. What do patients report regarding their real-world function following triplane metatarsophalangeal joint arthrodesis for hallux valgus? J Foot Ankle Surg, 2023, 62(5): 905-911.
35.	Thong YJ, Davies BM, Bedi H. Return to activities in younger individuals (<60 yrs) undergoing first metatarsophalangeal joint arthrodesis. J Foot Ankle Surg, 2025, 64(2): 192-196.
36.	Koutsouradis P, Savvidou OD, Stamatis ED. Arthrodesis of the first metatarsophalangeal joint: The “when and how”. World J Orthop, 2021, 12(7): 485-494.
37.	So E, Wilson M, Chu AK, et al. Incidence of nonunion of the first metatarsophalangeal joint arthrodesis after failed implant arthroplasty: a systematic review. Foot Ankle Spec, 2024, 17(1): 78-86.
38.	Weber C, Yao D, Schwarze M, et al. Risk analysis of nonunion after first metatarsophalangeal joint arthrodesis. Foot Ankle Spec, 2021, 14(2): 120-125.
39.	Alkaramany E, Rodriguez-Materon S, Dai AZ, et al. Rate of subsequent hallux interphalangeal joint fusion after first metatarsophalangeal fusion: a national database study with verified continued patient enrollment. Foot Ankle Int, 2025, 46(6): 629-632.
40.	Myerson MS, Schon LC, McGuigan FX, et al. Result of arthrodesis of the hallux metatarsophalangeal joint using bone graft for restoration of length. Foot Ankle Int, 2000, 21(4): 297-306.
41.	Luk PC, Johnson JE, McCormick JJ, et al. First metatarsophalangeal joint arthrodesis technique with interposition allograft bone block. Foot Ankle Int, 2015, 36(8): 936-943.
42.	Malhotra K, Nunn T, Qamar F, et al. Interposition bone block arthrodesis for revision hallux metatarsophalangeal joint surgery: a case series. Foot Ankle Int, 2015, 36(5): 556-564.
43.	Bei C, Gross CE, Adams S, et al. Dual plating with bone block arthrodesis of the first metatarsophalangeal joint: A clinical retrospective review. Foot Ankle Surg, 2015, 21(4): 235-239.
44.	Aiyer AA, Myerson MS, Dall G, et al. The biomechanical evaluation of revision first metatarsophalangeal arthrodesis: a cadaveric study. Foot Ankle Spec, 2015, 8(5): 369-377.
45.	Mao DW, Zheng C, Amatullah NN, et al. Salvage arthrodesis for failed first metatarsophalangeal joint arthroplasty: A network meta-analysis. Foot Ankle Surg, 2020, 26(6): 614-623.
46.	Burke JE, Shi GG, Wilke BK, et al. Allograft interposition bone graft for first metatarsal phalangeal arthrodesis: salvage after bone loss and shortening of the first ray. Foot Ankle Int, 2021, 42(8): 969-975.
47.	Sebag JA, Clements RC, Togher CJ, et al. The first metatarsophalangeal joint: updates on revision arthrodesis and malunions. Clin Podiatr Med Surg, 2023, 40(4): 569-580.
48.	Hodel S, Viehöfer A, Wirth S. Minimally invasive arthrodesis of the first metatarsophalangeal joint: A systematic literature review. Foot Ankle Surg, 2020, 26(6): 601-606.
49.	Angthong C, Rajbhandari P, Handoyo HR. Minimally invasive surgery versus an arthroscopic procedure for the first metatarsophalangeal arthrodesis: A comparative study of the effectiveness and safety profile. Eur J Orthop Surg Traumatol, 2021, 31(3): 497-501.
50.	Chong HC, Lui TH. Arthroscopic arthrodesis of the first metatarsophalangeal joint in hallux valgus deformity using medial and toe web portals. Arthrosc Tech, 2023, 12(7): e1171-e1177.
51.	Minelli M, deMeireles AJ, Marciano GF, et al. Percutaneous hallux fusion with calcaneus bone autograft: a retrospective cohort study of clinical and radiographic outcomes. Arch Orthop Trauma Surg, 2025, 145(1): 123. doi: 10.1007/s00402-024-05613-x.
52.	Hoveidaei AH, Roshanshad A, Vosoughi AR. Clinical and radiological outcomes after arthrodesis of the first metatarsophalangeal joint. Int Orthop, 2021, 45(3): 711-719.
53.	Dyke WB, Bank N, Lauck BJ, et al. Impact of preoperative pes planus on orthopaedic implant removal following first metatarsophalangeal joint arthrodesis: A retrospective analysis. J Foot Ankle Surg, 2025, 64(5): 507-510.
54.	Noble DM, Sumpter A, Small B, et al. Clinical, radiographic, and patient-reported outcomes of first metatarsophalangeal interposition arthrodesis using porous titanium wedges. Foot Ankle Spec, 2025, 18(4): 432-437.

1. Clutton HH. The treatment of hallux valgus. St Thomas Hosp Rep, 1892-1893, 22: 1-12.
2. Attia AK, Heier KA. First metatarsophalangeal arthrodesis for the failed hallux. Foot Ankle Clin, 2022, 27(4): 723-744.
3. Coughlin MJ. Hallux valgus. J Bone Joint Surg (Am), 1996, 78(6): 932-966.
4. Belfiore S, Vaggi S, Vitali F, et al. Rigid iatrogenic hallux varus: a decades’ worth experience with arthrodesis of the metatarsophalangeal joint. Int Orthop, 2024, 48(11): 2923-2929.
5. Anastasio AT, Shaffrey I, Easley ME. Surgical management of failed first metatarsophalangeal joint arthroplasty. Foot Ankle Clin, 2024, 29(3): 541-556.
6. de Bot RTAL, Veldman HD, Eurlings R, et al. Metallic hemiarthroplasty or arthrodesis of the first metatarsophalangeal joint as treatment for hallux rigidus: A systematic review and meta-analysis. Foot Ankle Surg, 2022, 28(2): 139-152.
7. LaCoste KL, Andrews NA, Ray J, et al. First metatarsophalangeal joint arthrodesis: a narrative review of fixation constructs and their evolution. Cureus, 2021, 13(4): e14458. doi: 10.7759/cureus.14458.
8. Prat D, Sourugeon Y, Haghverdian BA, et al. “In situ” joint preparation technique for first metatarsophalangeal arthrodesis: a retrospective comparative review of 388 cases. J Foot Ankle Surg, 2023, 62(5): 855-861.
9. Saltzman CL, Anderson RB, Coughlin MJ. Mann’s surgery of the foot and ankle. 9th ed. 2013: 269.
10. Bayomy AF, Aubin PM, Sangeorzan BJ, et al. Arthrodesis of the first metatarsophalangeal joint: a robotic cadaver study of the dorsiflexion angle. J Bone Joint Surg (Am), 2010, 92(8): 1754-1764.
11. Strony JT, Rascoe AS, Marcus RE. Validation of the artificial floor technique in first metatarsophalangeal joint arthrodesis. Clin Orthop Relat Res, 2022, 480(10): 2002-2009.
12. Kang YS, Bridgen A. First metatarsophalangeal joint arthrodesis/fusion: a systematic review of modern fixation techniques. J Foot Ankle Res, 2022, 15(1): 30. doi: 10.1186/s13047-022-00540-9.
13. Balu AR, Baumann AN, Tsang T, et al. Evaluating the biomechanical integrity of various constructs utilized for first metatarsophalangeal joint arthrodesis: a systematic review. Materials (Basel), 2023, 16(19): 6562. doi: 10.3390/ma16196562.
14. Haimes MA, Roberts MS, Bougioukas L, et al. Analysis of the costs and complications of first metatarsophalangeal joint arthrodesis comparing locked and non-locked plate fixation constructs. J Am Acad Orthop Surg, 2023, 31(21): e1012-e1020.
15. Challagundla SR, Thomas R, Ferdinand R, et al. First metatarsophalangeal joint arthrodesis using memory staples: clinical and functional results. Foot Ankle Spec, 2021, 14(5): 410-414.
16. Romere CM, Sidrak JP, Hollenbeck JFM, et al. Biomechanical comparison between fixation techniques for first-metatarsophalangeal joint arthrodesis. Foot Ankle Int, 2025, 46(8): 895-902.
17. Tytgat HE, Wuite S, Matricali GA. Arthrodesis of the first metatarsophalangeal joint using an intraosseous fixation device. Acta Orthop Belg, 2022, 88(1): 135-142.
18. Kuik L, Łuczkiewicz P. Safety and efficacy of medial plate in first metatarsophalangeal joint arthrodesis. Ortop Traumatol Rehabil, 2021, 23(3): 205-212.
19. Daszkiewicz K, Rucka M, Czuraj K, et al. Effect of lag screw on stability of first metatarsophalangeal joint arthrodesis with medial plate. Peer J, 2024, 12: e16901. doi: 10.7717/peerj.16901.
20. Mann RA, Katcherian DA. Relationship of metatarsophalangeal joint fusion on the intermetatarsal angle. Foot Ankle, 1989, 10(1): 8-11.
21. Pydah SK, Toh EM, Sirikonda SP, et al. Intermetatarsal angular change following fusion of the first metatarsophalangeal joint. Foot Ankle Int, 2009, 30(5): 415-418.
22. Dayton P, Feilmeier M, Hunziker B, et al. Reduction of the intermetatarsal angle after first metatarsal phalangeal joint arthrodesis: a systematic review. J Foot Ankle Surg, 2014, 53(5): 620-623.
23. Dusch T, Guareschi A, Moore A, et al. Changes in radiographic alignment following metatarsophalangeal fusion, distal metatarsal osteotomy, and lapidus. Foot Ankle Spec, 2025, 18(5): 525-534.
24. Doty J, Coughlin M, Hirose C, et al. Hallux metatarsophalangeal joint arthrodesis with a hybrid locking plate and a plantar neutralization screw: a prospective study. Foot Ankle Int, 2013, 34(11): 1535-1540.
25. von Deimling C, Tondelli T, Brunner S, et al. Achieving high union rates after first metatarsophalangeal joint arthrodesis: Radiographic outcomes and technical pitfalls. World J Orthop, 2023, 14(6): 436-442.
26. DeFrino PF, Brodsky JW, Pollo FE, et al. First metatarsophalangeal arthrodesis: a clinical, pedobarographic and gait analysis study. Foot Ankle Int, 2002, 23(6): 496-502.
27. van Doeselaar DJ, Heesterbeek PJ, Louwerens JW, et al. Foot function after fusion of the first metatarsophalangeal joint. Foot Ankle Int, 2010, 31(8): 670-675.
28. Poggio D, de Retana PF, Borda D, et al. Analysis of the clinical score progressions during the first year after first MTPJ fusion. Foot Ankle Int, 2010, 31(7): 578-583.
29. Roth W, Hoch C, Gross CE, et al. First metatarsophalangeal arthrodesis outcomes for hallux rigidus versus hallux valgus. Foot Ankle Surg, 2023, 29(1): 50-55.
30. El Masry S, Boden AL, DiGiovanni GM, et al. A comparison of PROMIS scores of metatarsophalangeal joint arthrodesis and polyvinyl alcohol hydrogel implant hemiarthroplasty for hallux rigidus. JB JS Open Access, 2024, 9(3): e23.00158. doi: 10.2106/JBJS.OA.23.00158.
31. D’sa P, Vaidhyanathaswamy S, Teoh KH, et al. The ability to wear heeled footwear following first metatarsophalangeal joint fusion. Foot Ankle Surg, 2022, 28(4): 510-513.
32. Webb AR, Manz WJ, Fuqua A, et al. Effect of obesity on patient-perceived outcomes after first metatarsophalangeal joint arthrodesis. Foot Ankle Spec, 2024, 17(1): 58-66.
33. Baumann AN, Walley KC, Kermanshahi N, et al. Return to sport after first metatarsophalangeal arthrodesis: a systematic review. Foot Ankle Int, 2023, 44(12): 1319-1327.
34. Dayton M, Dayton P, Togher CJ, et al. What do patients report regarding their real-world function following triplane metatarsophalangeal joint arthrodesis for hallux valgus? J Foot Ankle Surg, 2023, 62(5): 905-911.
35. Thong YJ, Davies BM, Bedi H. Return to activities in younger individuals (<60 yrs) undergoing first metatarsophalangeal joint arthrodesis. J Foot Ankle Surg, 2025, 64(2): 192-196.
36. Koutsouradis P, Savvidou OD, Stamatis ED. Arthrodesis of the first metatarsophalangeal joint: The “when and how”. World J Orthop, 2021, 12(7): 485-494.
37. So E, Wilson M, Chu AK, et al. Incidence of nonunion of the first metatarsophalangeal joint arthrodesis after failed implant arthroplasty: a systematic review. Foot Ankle Spec, 2024, 17(1): 78-86.
38. Weber C, Yao D, Schwarze M, et al. Risk analysis of nonunion after first metatarsophalangeal joint arthrodesis. Foot Ankle Spec, 2021, 14(2): 120-125.
39. Alkaramany E, Rodriguez-Materon S, Dai AZ, et al. Rate of subsequent hallux interphalangeal joint fusion after first metatarsophalangeal fusion: a national database study with verified continued patient enrollment. Foot Ankle Int, 2025, 46(6): 629-632.
40. Myerson MS, Schon LC, McGuigan FX, et al. Result of arthrodesis of the hallux metatarsophalangeal joint using bone graft for restoration of length. Foot Ankle Int, 2000, 21(4): 297-306.
41. Luk PC, Johnson JE, McCormick JJ, et al. First metatarsophalangeal joint arthrodesis technique with interposition allograft bone block. Foot Ankle Int, 2015, 36(8): 936-943.
42. Malhotra K, Nunn T, Qamar F, et al. Interposition bone block arthrodesis for revision hallux metatarsophalangeal joint surgery: a case series. Foot Ankle Int, 2015, 36(5): 556-564.
43. Bei C, Gross CE, Adams S, et al. Dual plating with bone block arthrodesis of the first metatarsophalangeal joint: A clinical retrospective review. Foot Ankle Surg, 2015, 21(4): 235-239.
44. Aiyer AA, Myerson MS, Dall G, et al. The biomechanical evaluation of revision first metatarsophalangeal arthrodesis: a cadaveric study. Foot Ankle Spec, 2015, 8(5): 369-377.
45. Mao DW, Zheng C, Amatullah NN, et al. Salvage arthrodesis for failed first metatarsophalangeal joint arthroplasty: A network meta-analysis. Foot Ankle Surg, 2020, 26(6): 614-623.
46. Burke JE, Shi GG, Wilke BK, et al. Allograft interposition bone graft for first metatarsal phalangeal arthrodesis: salvage after bone loss and shortening of the first ray. Foot Ankle Int, 2021, 42(8): 969-975.
47. Sebag JA, Clements RC, Togher CJ, et al. The first metatarsophalangeal joint: updates on revision arthrodesis and malunions. Clin Podiatr Med Surg, 2023, 40(4): 569-580.
48. Hodel S, Viehöfer A, Wirth S. Minimally invasive arthrodesis of the first metatarsophalangeal joint: A systematic literature review. Foot Ankle Surg, 2020, 26(6): 601-606.
49. Angthong C, Rajbhandari P, Handoyo HR. Minimally invasive surgery versus an arthroscopic procedure for the first metatarsophalangeal arthrodesis: A comparative study of the effectiveness and safety profile. Eur J Orthop Surg Traumatol, 2021, 31(3): 497-501.
50. Chong HC, Lui TH. Arthroscopic arthrodesis of the first metatarsophalangeal joint in hallux valgus deformity using medial and toe web portals. Arthrosc Tech, 2023, 12(7): e1171-e1177.
51. Minelli M, deMeireles AJ, Marciano GF, et al. Percutaneous hallux fusion with calcaneus bone autograft: a retrospective cohort study of clinical and radiographic outcomes. Arch Orthop Trauma Surg, 2025, 145(1): 123. doi: 10.1007/s00402-024-05613-x.
52. Hoveidaei AH, Roshanshad A, Vosoughi AR. Clinical and radiological outcomes after arthrodesis of the first metatarsophalangeal joint. Int Orthop, 2021, 45(3): 711-719.
53. Dyke WB, Bank N, Lauck BJ, et al. Impact of preoperative pes planus on orthopaedic implant removal following first metatarsophalangeal joint arthrodesis: A retrospective analysis. J Foot Ankle Surg, 2025, 64(5): 507-510.
54. Noble DM, Sumpter A, Small B, et al. Clinical, radiographic, and patient-reported outcomes of first metatarsophalangeal interposition arthrodesis using porous titanium wedges. Foot Ankle Spec, 2025, 18(4): 432-437.

Chinese Journal of Reparative and Reconstructive Surgery

First metatarsophalangeal joint arthrodesis for severe hallux valgus deformity

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