Restricted accessResearch articleFirst published online 2025
Minimally Invasive First Metatarsophalangeal Joint Arthrodesis With a Low-Profile Hybrid Locking Plate and a Beveled Compression Screw: A Surgical Technique
Arthrodesis of the first metatarsophalangeal joint (MTPJ) is a valuable intervention for a variety of hallux pathologies and is still considered the gold standard treatment for advanced hallux rigidus, one of the most commonly encountered pathologies of the forefoot. With the advent and expansion of minimally invasive surgery (MIS) techniques, MIS First MTPJ arthrodesis offers a new approach to treat hallux conditions with the potential to limit complications and further enhance patient satisfaction. We describe a technique that affords the benefits of MIS surgery without compromising the biomechanical superiority of a dorsal hybrid low-profile plate with a beveled, partially threaded compression screw.
Level of Evidence: Therapeutic, Level V: Technique article
SchipperONDayJRayGSJohnsonAH.Percutaneous techniques in orthopedic foot and ankle surgery. Orthop Clin North Am. 2020;51(3):403-422.
2.
BrodskyJWPassmoreRNPolloFEShabatS.Functional outcome of arthrodesis of the first metatarsophalangeal joint using parallel screw fixation. Foot Ankle Int. 2005;26(2):140-146.
3.
CoughlinMJ.Arthrodesis of the first metatarsophalangeal joint. Orthop Rev. 1990;19:177-186.
4.
CoughlinMJGrebingBRJonesCP.Arthrodesis of the first metatarsophalangeal joint for idiopathic hallux valgus: intermediate results. Foot Ankle Int. 2005;26(10):783-792.
CrowellAVanJCMeyrAJ.Early weight-bearing after arthrodesis of the first metatarsal-phalangeal joint: a systematic review of the incidence of non-union. J Foot Ankle Surg. 2018;57(6):1200-1203.
7.
DeSandisBPinoALevineDS, et al. Functional outcomes following first metatarsophalangeal arthrodesis. Foot Ankle Int. 2016;37:715-721.
8.
MannRA. Disorders of the first metatarsophalangeal joint. J. Am. Acad. Orthop. Surg. 1995;3:34-43.
9.
AngthongCRajbhandariPHandoyoHR.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.
10.
BauerT.Percutaneous first metatarsophalangeal joint fusion. Open Orthop J. 2017;11:724-731.
11.
CarlucciSPariseACSantini-AraujoMG, et al. Minimally-invasive hallux arthrodesis with endomedullary and a crossed screw fixation. Foot Ankle Surg. 2020;26(7):744-749.
CarroLPVallinaBB.Arthroscopic-assisted first metatarsophalangeal joint arthrodesis. Arthroscopy. 1999;15(2):215-217.
14.
DugganJLGuildTTStanwoodKCMillerCP.Minimally invasive vs open approach for first metatarsophalangeal joint arthrodesis: short report of early results. Foot Ankle Int. 2024;45(7):723-727.
15.
FanousRNRidgersSSottAH.Minimally invasive arthrodesis of the first metatarsophalangeal joint for hallux rigidus. Foot Ankle Surg. 2014;20(3):170-173.
16.
GhandourSKnebelAEftekhariMMillerC.Minimally invasive fusion of the first metatarsophalangeal joint: a technical report. Tech Foot Ankle Surg. 2024;23(2):52-59.
17.
HodelSViehöferAWirthS.Minimally invasive arthrodesis of the first metatarsophalangeal joint: a systematic literature review. Foot Ankle Surg. 2020;26(6):601-606.
KaufmannG.Minimally invasive arthroscopic-assisted arthrodesis of the first metatarsophalangeal joint. Oper Orthop Traumatol. 2021;33(6):465-470.
20.
SottAH.Minimally invasive arthrodesis of 1st metatarsophalangeal joint for hallux rigidus. Foot Ankle Clin. 2016;21(3):567-576.
21.
ZhaoJZKaiserPBDeGruccioCFarinaEMMillerCP.Quality of MIS vs open joint preparations of the foot and ankle. Foot Ankle Int. 2022;43(7):948-956.
22.
AiyerAAMyersonMSDallGPriceJWidmerJ.The biomechanical evaluation of revision first metatarsophalangeal arthrodesis: a cadaveric study. Foot Ankle Spec. 2015;8(5):369-377.
23.
BaluARBaumannANTsangT, et al. Evaluating the biomechanical integrity of various constructs utilized for first metatarsophalangeal joint arthrodesis: a systematic review. Materials. 2023;16(19):6562.
24.
BennettGLKayDBSabattaJ.First metatarsophalangeal joint arthrodesis: an evaluation of hardware failure. Foot Ankle Int. 2005;26(8):593-596.
25.
CurranMGMurphyEPMurphyFMFenelonCGKearnsSR.Functional capabilities after first metatarsal phalangeal joint arthrodesis using a locking plate and compression screw construct. J Foot Ankle Surg. 2022;61(1):79-83.
26.
FuldRS3rdKumparatanaPKelleyJ, et al. Biomechanical comparison of low-profile contoured locking plate with single compression screw to fully threaded compression screws for first MTP fusion. Foot Ankle Int. 2019;40(7):836-844.
27.
HuntKJBarrCRLindseyDPChouLB.Locked versus nonlocked plate fixation for first metatarsophalangeal arthrodesis: a biomechanical investigation. Foot Ankle Int. 2012;33(11):984-990.
28.
HuntKJEllingtonJKAndersonRBCohenBEDavisWHJonesCP.Locked versus nonlocked plate fixation for hallux MTP arthrodesis. Foot Ankle Int. 2011;32(7):704-709.
29.
KumarSPradhanRRosenfeldPF.First metatarsophalangeal arthrodesis using a dorsal plate and a compression screw. Foot Ankle Int. 2010;31:797-801.
30.
MandellDKarbassiJZhouHBurroughsBAurigemmaPPatelAR.A locking compression plate versus the gold standard non-locking plate with lag screw for first metatarsophalangeal fusion: a biomechanical comparison. Foot. 2018;34:69-73.
31.
MolloySBurkhartBGJasperLESolanMCCampbellJTBelkoffSM.Biomechanical comparison of two fixation methods for first metatarsophalangeal joint arthrodesis. Foot Ankle Int. 2003;24(2):169-171.
32.
NeufeldSKParksBGNaseefGSMelamedEASchonLC.Arthrodesis of the first metatarsophalangeal joint: a biomechanical study comparing memory compression staples, cannulated screws, and a dorsal plate. Foot Ankle Int. 2002;23(2):97-101.
33.
PolitiJJohnHNjusGBennettGLKayDB.First metatarsal-phalangeal joint arthrodesis: a biomechanical assessment of stability. Foot Ankle Int. 2003;24(4):332-337.
34.
SchaferKABaldiniTHamatiMBackusJDHuntKJMcCormickJJ.Two orthogonal nitinol staples and combined nitinol staple-screw constructs for a first metatarsophalangeal joint arthrodesis: a biomechanical cadaver study. Foot Ankle Int. 2022;43(11):1493-1500.
35.
WestTAPollardJDCarpenterDMDeTommasoJPatelSB.Crossed screw fixation versus dorsal plating for first metatarsophalangeal joint arthrodesis: a retrospective cohort study. J Foot Ankle Surg. 2022;61(1):32-36.
36.
DotyJCoughlinMHiroseCKempT.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
37.
CoughlinMJShurnasPS.Hallux rigidus grading and long-term results of operative treatment. J Bone Joint Surg Am. 2003;85(11):2072-2088.
