Striding Ahead—Functional Outcomes of First Metatarsophalangeal Joint Arthrodesis Using Low-profile Dorsal Plate Fixation: A Comparative Study

Background: First metatarsophalangeal (MTP) joint arthrodesis is commonly used to treat severe forefoot pathologies, including hallux valgus and hallux rigidus, aiming to relieve pain and restore foot stability.This study assesses functional and biomechanical outcomes postarthrodesis using low-profile dorsal plate fixation.Materials and methods: A cross-sectional study was conducted with 44 participants-22 cases (22 feet) with first MTP arthrodesis and 22 matched controls.Functional outcomes were measured using the Manchester-Oxford Foot Questionnaire (MOXFQ), while gait and plantar pressure were evaluated with the gait analysis instrumented treadmill (GAITRite) and EMED sensor foot (EMED-SF) systems, respectively.Radiographic assessments were also performed to confirm joint fusion and assess secondary arthritis.Results: MOXFQ scores indicated high patient satisfaction in the arthrodesis group, with no significant difference from controls (p = 0.129).Gait analysis showed no disruption in step width, step length, or stance phase, demonstrating preserved gait mechanics (p > 0.05).Plantar pressure analysis revealed normal weight distribution, with no significant differences in peak pressures or total foot force compared to controls (p > 0.05).Radiographs confirmed 100% fusion and no adjacent joint arthritis.Conclusion: First MTP arthrodesis using low-profile dorsal plates provides effective symptom relief, preserves gait mechanics, and maintains normal plantar pressure, proving beneficial for patients with severe forefoot pathologies. Clinical significance:The technique achieves high fusion rates and stable joint function, with minimal risk of secondary complications, offering a reliable surgical option for advanced MTP pathologies.