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Learn the First MTP Fusion-Crossed screws technique surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the First MTP Fusion-Crossed screws technique surgical procedure.

A 1st MTP (metatarsophalangeal ) joint fusion  is a highly versatile operation both in terms of the conditions which can be treated as well as in terms of the function possible after successful fusion.

A union rate of 90% plus is recorded in most series using current techniques. Success defined in terms of patient satisfaction rates though can be slightly lower than those of radiographic union of the fusion .

The keys to operative success are careful joint preparation, positioning and appropriate fixation.

There are various ways of fixing the fusion, most commonly  a single axial compressive screw combined with  a dorsal neutralising or compression plate . The technique detailed in this operation is a “crossed-screws” technique which differs only in the final mode of fixation.

 

Author: Mark Herron FRCS

Institution: The Wellington Hospital , London