Michael W Downey, Justin J Fleming and Benjamin Elgamil
Tarsalmetatarsal (TMT) osteoarthritis is encountered frequently. Pathology at the TMT joints play a role in continued foot fatigue and further compensation of gait laterally to avoid discomfort over the medial and central columns of the midfoot. Sequeula and further pathology to the central TMT joints are multifactorial. Recalcitrant pain, subtle instability, and arthrosis are commonly observed. Patients who fail nonoperative treatment are subjective to reconstructive surgical treatment. We present a straightforward stepwise technique for an in situ arthrodesis of the central TMT joints. We focus on the principles of the dowel arthrodesis with trephine reamers, cancellous bone plugs, and compressive locking plate fixation for a reproducible corrective midfoot fusion.