Arthroscopic Arthrodesis of the First Metatarsophalangeal Joint in Hallux Valgus Deformity Using Medial and Toe Web Portals

Arthrodesis of the first metatarsophalangeal joint is indicated for severe hallux valgus deformity. Open arthrodesis requires extensive soft-tissue dissection. Recently, a technique of arthroscopic first metatarsophalangeal arthrodesis in hallux valgus deformity has been reported. This approach includes endoscopic lateral release of the first metatarsophalangeal joint via the plantar and toe web portals, followed by arthroscopic arthrodesis of the joint via the medial and dorsolateral portals. Endoscopic lateral release of the first metatarsophalangeal joint can convert the fixed hallux valgus deformity into a flexible one and reduce the stress over the screws and risk of loss of reduction and nonunion. The purpose of this Technical Note is to report a modified technique of arthroscopic first metatarsophalangeal arthrodesis in hallux valgus deformity. In this modified technique, the arthrodesis is performed via the medial and toe web portals and creation of the dorsolateral portal is not needed. A 2.7-mm arthroscope is used for the arthrodesis procedure instead of a 1.9-mm arthroscope. This can improve fluid inflow and visualization.