Compression-screw arthrodesis of the first metatarsophalangeal joint of the foot.

The function of the foot is disturbed by a stiff, painful great toe. This problem can be overcome with a new technique for fusing the first metarsophalangeal joint at the desired angle with the joint surfaces conservatively resected with parallel, oblique cuts. The bones are then approximated and fixed in 20 degrees-30 degrees of dorsoflexion with two compression screws. The operation should shorten the toe 1.0 to 1.5 cm and give it a moderately valgus orientation. No additional fixation is used. Twenty patients were treated in a prospective study, and all fusions healed. After one year, 13 patients were free of symptoms, five had minimal symptoms, and two still had pain; poor results may be related to the malposition of the fused joint. The technique was simple, involved limited discomfort for the patient, and generally produced a functioning forefoot.