The great toe IP joint is the single interphalangeal joint of the hallux, moving through the swing phase of gait as the toe clears the ground. IP joint OA of the hallux produces painful terminal gait extension — the windlass mechanism requires full IP extension for efficient push-off, and IP arthritis prevents this. IP joint fusion is the definitive treatment for hallux IP arthritis.
Hallux IP joint fusion is performed for end-stage IP joint OA. The joint is fused in 0-5 degrees of flexion with the toe plantargrade to maintain floor contact during gait. A single axial screw or two-screw construct provides reliable fixation.
End-stage great toe interphalangeal joint OA producing push-off pain managed with IP joint fusion in neutral position.
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