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First MTP Joint Distraction Arthrodesis With Cancellous Autograft and Bridge Plating: A Novel Surgical Technique to Restore Maximum Length

Loewy, Evan M. MD; Clare, Michael P. MD

Techniques in Foot & Ankle Surgery: June 2016 - Volume 15 - Issue 2 - p 103–109
doi: 10.1097/BTF.0000000000000113
CME Article

A novel technique used in a small series of patients is presented that describes a management option for the difficult situation of hallux metatarsophalangeal pathology with associated first-ray shortening and transfer lesions. Distraction arthrodesis was performed using proximal tibial cancellous autograft and locked plating to achieve an average of 10.6 mm length restoration with all patients showing radiographic signs of union by the eighth postoperative week and resolution of transfer metatarsalgia. This novel technique shows promise for reliable outcomes in a variety of historically difficult clinical situations such as inflammatory arthritis and salvage arthrodesis.

Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.

*PGY 3 Orthopedic Resident, Department of Orthopaedics and Sports Medicine, USF Health Morsani College of Medicine, University of South Florida

Attending Orthopedic Surgeon, Division of Foot & Ankle Surgery, The Florida Orthopaedic Institute, Tampa, FL

The authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Address correspondence and reprint requests to Evan M. Loewy, MD, Department of Orthopaedics and Sports Medicine, USF Health Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, #710, Tampa, FL 33606. E-mail:


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