Femoral Head Allograft for First Metatarsal Phalangeal Joint Fusion Using a Reamer Technique to Limit Graft Length

摘要

The use of interpositional bone grafting for arthrodesis of the first metatarsophalangeal joint can be a technically challenging procedure. A fresh-frozen femoral head allograft can provide an appropriate graft for lengthening and ultimate fusion. It has been well-documented in published studies that larger grafts at this site increase the risk of complications. When the joint is resected in a "square" fashion, length is actually lost from the first metatarsal head. We present a technique using a reamer applied to 1 side of the graft and the first metatarsal head in a "cup-and-cone" fashion, thereby limiting the total length of the actual graft size. This technique allows for easy positioning and lengthening, increasing the chance of graft incorporation at the fusion sites. (C) 2016 by the American College of Foot and Ankle Surgeons. All rights reserved.