Professional Podiatry Services of New York
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Foot & ankle surgery

First MTP Joint Fusion

First metatarsophalangeal (MTP) joint fusion joins the two bones of the big toe joint so they heal as one. It is a reliable treatment for advanced arthritis of the big toe and for some severe or revision bunions.

Schedule a surgical consultation
Bring any prior imaging or operative reports.

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The problem being treated

An arthritic big toe joint is painful with every step. Removing the joint surfaces and fusing them eliminates the painful motion.

Related conditions: Big Toe Arthritis (Hallux Rigidus), Bunions, Foot & Ankle Arthritis.

When surgery may be appropriate

  • Advanced hallux rigidus
  • Severe bunion with arthritis
  • Failed prior big toe surgery

Earlier-stage arthritis may be better treated with joint-preserving procedures such as cheilectomy.

How the procedure works

  • The remaining cartilage is removed from both sides of the joint.
  • The toe is positioned for comfortable walking and shoe wear.
  • A plate and/or screws hold the joint while it fuses.

Typical restrictions after surgery

  • Heel-weighted walking or non-weight-bearing as directed
  • Boot or surgical shoe for several weeks
  • Elevation for swelling

Your surgeon will give instructions specific to your procedure; these are general guidelines only.

General recovery phases

  1. Weeks 0–2Rest and elevation.
  2. Weeks 2–8Protected weight-bearing; X-rays track fusion.
  3. Weeks 8–12Gradual return to supportive shoes.
  4. Months 3–6Return to most activities.

Frequently asked questions

Will I walk with a limp?

Once fused, most people walk normally. The toe is positioned so that the foot rolls through the step comfortably.

Can I wear heels?

Low heels are usually manageable; high heels become difficult.

Outcomes vary from patient to patient. This page is educational and does not replace a consultation; candidacy is determined after an examination and imaging.