Hypermobility of the first tarsometatarsal joint

Hypermobility of the first tarsometatarsal joint that is associated with symptomatic hallux valgus can be treated effectively with arthrodesis of the first tarsometatarsal joint. The literature indicates that the chance of achieving a pain-free, asymptomatic foot after this procedure ranges from approximately 50% to 75%. Approximately 10% of patients will have unsatisfactory clinical outcomes [2,4,5-7]. The remaining patients will have a definite improvement in their symptoms, although they remain symptomatic with certain activities. Some patients will continue to have hypermobility of the first ray after first tarsometatarsal arthrodesis because of the motion at the unfused talonavicular and navicular cuneiform joints. Patients should be advised that secondary procedures may be necessary for such conditions as hardware removal and symptomatic nonunion.