Resection arthroplasty of the metatarsophalangeal joint of the great toe has been commonly used for many most frequently used procedures have been the so-called Mayo operation, a subtotal resection of the metatarsal head, and the Keller operation, a resection of the base of the proximal phalanx. The Mayo procedure may be associated with positional deformities, loss of flexion power and transfer of weight-bearing forces to the lateral metatarsal heads. Unsatisfactory results are not uncommon in the Keller procedure and relate to the failure of development and maintenance of an adequate joint space.Arthrodesis as a treatment for bunion deformity may be complicated by malalignment and failure to obtain fusion.'" Metatarsal osteotomy procedures may lead to less than optimal results due to recurrence of deformity, non-union, and avascular necrosis in cases of distal metatarsal osteotomies.
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