Arthrodesis of the first metatarsophalangeal joint was performed in
eleven patients (sixteen feet) after a Keller procedure had failed.
Multiple intramedullary threaded Steinmann pins were used to fix the bone
at the site of the arthrodesis, and a successful arthrodesis was achieved
in each patient. Interposition of a graft of bone from the iliac crest was
done in four feet with an excessively short hallux. Lateral metatarsalgia
that was due to intractable keratoses on the plantar part of the foot was
relieved in eleven (92 per cent) of the twelve feet that had it
preoperatively. Cock-up deformity of the hallux was also improved. Residual
stiffness of the interphalangeal joints, which was a major preoperative
problem, was not improved. Arthrodesis of the first metatarsophalangeal
joint is a useful procedure to salvage a failed result of the Keller
procedure.