Abstract
Arthroscopic treatments for the first metatarsophalangeal joint have not spread fully
owing to a number of factors. First, in the common arthroscopic view, the joint is
observed from above, which makes the structures difficult to grasp and the dorsal
aspect of the joint difficult to visualize and treat. Second, techniques for widening
the view have not yet been reported. Third, the portals necessary for observation
and treatment with hallux sesamoids have not yet been established. Finally, techniques
for detecting the sesamoids have not been previously reported. We have developed a
method for first metatarsophalangeal joint arthroscopy by treating 14 patients with
hallux rigidus and 9 patients with hallux sesamoid disorders. We report a new method
that combines a variety of arthroscopic techniques. Our study has 4 novel points.
First, in our arthroscopic technique, the joint can be examined from the medial side
because traction is directly and horizontally applied to the great toe using an adjustable
traction device with the surgeon standing on the unoperated side. The technique enables
observation of the dorsal aspect of the metatarsal head and proximal phalanx and makes
the structures easier to grasp. Second, the coagulator technique as an arthroscopic
aid is demonstrated. Third, all aspects of the joint, including the sesamoids, can
be observed through our 4 portals. Finally, techniques for detecting the sesamoids
are identified. We believe our novel method will ensure that arthroscopy of the first
metatarsophalangeal joint is easier than previously described methods.
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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