Foot & Ankle II Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Question 2)The radiograph is of a 58-year-old woman who has a painful hallux. She has pronation of the great toe upon standing, tightness of the adductor halluces, painless first metatarsophalangeal (MTP) range of motion, and pain at the first tarsometatarsal (TMT) joint. In addition to any distal soft-tissue procedure, the recommended surgical treatment should consist of Foot & AnkleQuestion 2) Figure Select the Correct AnswerFirst TMT arthrodesisFirst MTP arthrodesisDistal Chevron osteotomyProximal first metatarsal osteotomySilastic implant arthroplasty of the first MTP jointCorrect Answer: First TMT arthrodesis Explanation: This figure reveals substantial hallux valgus with metatarsus primus varus. This patient also has considerable pronation of the toe with adductor tightness. With the pain at the first TMT joint, the best procedure to correct her increased 1-2intermetatarsal angle and stabilize the tarsometatarsal joint is an arthrodesis, since proximal first metatarsal osteotomy alone would not address the pain at the proximal joint. Because she has good, painless range of motion at the first MTP joint, an arthrodesis or arthroplasty of the MTP joint is not preferred. A distal procedure will not address the increased 1-2 intramedullary angle. References: Source 2015 AAOS OITE Thompson IM, Bohay DR, Anderson JG. Fusion rate of first tarsometatarsal arthrodesis in the modified Lapidus procedure and flatfoot reconstruction. Foot Ankle Int. 2005 Sep;26(9):698-703. doi: 10.1177/107110070502600906. PMID: 16174499. Scranton PE, Coetzee JC, Carreira D. Arthrodesis of the first metatarsocuneiform joint: a comparative study of fixation methods. Foot Ankle Int. 2009 Apr;30(4):341-5. doi: 10.3113/FAI.2009.0341. PMID: 19356359 Wrong Answer: Please try again! Submit Post navigation Previous QuestionFoot & Ankle IIINext QuestionFoot & Ankle I
