Outcomes and Complications of First Tarsometatarsal Plantarflexion Bone Block Arthrodesis With a Precontoured Allograft Wedge

Given the observed high nonunion rate (42%) and revision rate (27%), this technique should be approached with caution. We believe patient selection and counseling regarding potential postoperative complications including high reoperation and nonunion rates as well as the potential to overlengthen or overcorrect first-ray positioning resulting in sesamoid overload symptoms are important to consider before proceeding with first-TMT plantarflexion allograft bone block arthrodesis.