What is done during a Midtarsal (MTP) fusion foot surgery?

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Last updated: April 7, 2025View editorial policy

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From the Research

MTP fusion foot surgery, also known as first metatarsophalangeal joint arthrodesis, is a procedure that permanently fuses the joint at the base of the big toe to treat severe arthritis, deformities, or instability, and it involves making an incision, removing damaged cartilage and bone surfaces, and securing the bones together with hardware such as screws, plates, or staples, as supported by the most recent study 1. During the surgery, the surgeon makes an incision over the top of the big toe joint, removes the damaged cartilage and bone surfaces, and prepares the bone ends to fit together precisely.

  • The bones are then positioned in the optimal functional alignment (typically with the toe slightly elevated and in a neutral position)
  • Secured together using hardware such as screws, plates, or staples.
  • Any bone defects may be filled with bone graft taken from elsewhere in the body or using synthetic materials, as seen in study 2. The incision is closed with sutures, and a sterile dressing and post-operative shoe or cast is applied. Following surgery, patients typically avoid weight-bearing for 2-6 weeks, followed by gradual return to activities using supportive footwear. Complete fusion of the bones usually takes 8-12 weeks, as reported in study 3. This procedure effectively eliminates pain by removing the arthritic joint but does result in permanent loss of motion at that joint, requiring adaptation to a modified gait pattern, with high levels of functionality after the procedure, as demonstrated in study 1. The use of a compression screw/locking plate construct for arthrodesis of the first MTPJ has been shown to be safe and successful, with approximately 97% of patients being very satisfied with the procedure and their ability to achieve activities of daily living post-operatively, as seen in study 1. Overall, MTP fusion foot surgery is a effective procedure for treating severe arthritis, deformities, or instability of the big toe joint, with good functional results and high patient satisfaction, as supported by the most recent and highest quality study 1.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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