Fusion removes painful joint motion and sets the toe in a functional position. It has been used after failed osteotomy, resection arthroplasty, recurrent deformity, hallux varus and failed implants. Studies report meaningful pain improvement, but revision fusion is more demanding than primary fusion.
Position is critical. Excessive dorsiflexion, plantarflexion, valgus or rotation can cause shoe problems and transfer pressure. Bone loss may require grafting, and previous surgery can increase the risk of nonunion or wound complications.
Advanced arthritis or damaged joint surfaces.
Severe stiffness with pain and deformity.
Failed resection or implant arthroplasty.
Recurrent deformity when joint preservation is unreliable.
Bone grafting or specialised fixation when bone stock is compromised.
Can patients walk normally after first MTP fusion?
Many patients achieve comfortable walking and good daily function, but the joint no longer bends. Footwear and high-demand activities may require adjustment, and outcomes depend strongly on fusion position and union.