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Arthrodesis Great Toe: A Closer Look

Great toe arthrodesis, also known as a great toe fusion, is the fusing together of the 1st metatarsalphalangeal joint (MTP joint). The need for surgical intervention can be due to arthritis, presence of a painful bunion, or injury.




Symptoms related to 1st MTP arthritis include; increased great toe pain with activity and aching pain at rest. Activities making the toe excessively bend and flex tend to exacerbate discomfort.


Formation of a bunion (also known as hallux valgus) occurs when the great toe begins to bend inward, thus creating a large, painful protrusion of the inner foot. Symptoms include pain with activity and discomfort of the 1st and 2nd toes due to rubbing together/overlapping. This too can be corrected by a great toe arthrodesis.


This procedure entails 2 screws being placed through the 1st MTP joint; initiating bone growth between the proximal phalanx of the great toe and the 1st metatarsal, fusing them together, forming one solid bone. Once fused together there will be limited motion. This limited motion will slightly decrease the amount of bend in the 1st toe, but will ultimately relieve prior pain.


Post-operative protocol includes a minimum of 8 weeks of immobilization and non-weight bearing. The first 2 weeks will include a padded, non-removable splint. At the 2 week follow up, sutures/staples will be removed and a short leg fiberglass cast will be applied. This cast will be changed in 3 weeks to accommodate for swelling loss, and a new one will be reapplied for a an additional 3 weeks. After the 8 weeks is up a CAM boot, or potentially a regular shoe, will be worn and weight bearing will begin as tolerated.


Source and for further information regarding this procedure from American Academy of Orthopaedic Surgeons (AAOS)