First Metatarsal Pathology: Can An Implant Provide A Long-Term Solution?

By Kerry Zang, DPM, Shahram Askari, DPM, A’Nedra Fuller, DPM, and Chris Seuferling, DPM
After a full evaluation of the patient’s treatment options, including the risks and complications of surgical intervention, the patient decided to undergo surgery to remove the malaligned hardware, reduce the fusion and utilize the Bio-Action Implant to help improve alignment and restore some of her joint function. We proceeded to perform an osteotomy of the fusion at a level where the length of the first metatarsal with the implant would approximate that of the previous joint line and maintain the proper metatarsal parabola. Postoperatively, the patient began immediate passive range of motion exercises and wore a below-knee cam-walker boot for two weeks. At two weeks, the patient was relatively pain-free and able to progress to athletic shoes. At recovery, the patient had resumed her normal activities and demonstrated approximately 75 degrees of unrestrained dorsiflexion at the first MPJ. In Conclusion Based on the results of the study, we believe the Bio-Action Implant is capable of providing at least nine years of satisfactory, relatively pain-free range of motion to a previously painful and non-functioning joint. By minimizing the amount of bone resection and preserving the plantar articulating/weightbearing surfaces, those who utilize the implant can maintain the flexor tendon function and sesamoid apparatus, and improve biomechanical function of the first ray. Dr. Zang is a Fellow of the American College of Foot and Ankle Surgeons. He practices in Mesa, Ariz. Dr. Seuferling practices in Oregon. Dr. Burks is a Fellow of the American College of Foot and Ankle Surgeons and is board certified in foot and ankle surgery. Dr. Burks practices in Little Rock, Ark. For related articles, see “How To Salvage A Failed First MPJ Implant” in the May 2005 issue of Podiatry Today or “How To Select The Right Procedure For Hallux Limitus” in the December 2003 issue. Also check out the archives at



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