If the first metatarsophalangeal joint(1st MPJ) is arthritic or mal-aligned in anyway, then it is possible to have arthritic damage of the hallux interphalangeus joint as well. It is more likely that there is increased pressure on the hallux interphalangeus joint if there is a more rectus or fused 1st MPJ joint such as post arthrodesis or hallux rigidus.
-If the 1st MPJ is rigid as a result of hallux rigidus or arthrodesis- it is recommended that a hallux interphalangeus arthroplasty be performed rather than a fusion of the interphalangeal joint. This procedure will help reduce any flexor hallucis longus tendinitis that may be concurrently taking place, but it will also give the hallux some “give” that was lost when the 1st MPJ was fused. The same is also true if the hallux interphalangeus joint is fused as a result of an arthrodesis or a fracture- it is helpful to perform a 1st MPJ arthroplasty rather than a 1st MPJ arthrodesis. Both should be fused only in extreme arthritic conditions.
-If arthrodesis of both the 1st MPJ and the HIJ must be accomplished, then with the distal and proximal phalanx in rectus position. It can be fixated with crossing pins rather than screws to increase fusion surface area.