Arthrodesis of the first metatarso-phalangeal joint with convex and concave drills

The arthrodesis of the metatarso-phalangeal joint of the hallux remains a reliable method in the treatment of the severe deformities caused by rheumatoid affection, recurrences of hallux valgus, iatrogenic varus and arthrosic hallux valgus (hallux rigidus). This operation is not crippling since the talocrural and interpahalangeal joints are preserved. The technique using a set of concentric drills allows a better positioning of the great toe, however it seems to generate a higher partial fusion rate but without repercussions on the final functional result. The metatarso-phalangeal arthrodesis of the great toe is a tried-and-tested method described by Groulier et al. [1]. A certain number of studies, mostly Anglo-Saxon, report it as early as the end of last century. Its merits have been gradually emphasized for the revisions or to treat the severe deformities of the great toe, either with arthrosis complications, painful stiffening or metatarsalgiae. The arthrodesis of the metatarso-phalangeal of the hallux was first stated in 1894 as a successful treatment, achieving good and stable results in case of severe hallux valgus. Varied techniques of arthrodesis of the metatarso-phalangeal of the hallux have been described and 60 different types have been listed.