Arthroscopy of the first metatarsophalangeal joint

We carried out 12 arthroscopies of the first metatarsophalangeal (MTP) join t in 11 patients over a five-year period. Their mean age was 30 years (15 t o 58) and the mean duration of symptoms before surgery was eight months (1 to 24), Six patients had an injury to the joint; all had swelling and tende rness with a reduced range of movement. In six patients, radiographs reveal ed no abnormality. Under general anaesthesia with a tourniquet the hallux is suspended by a la rge Chinese finger trap to distract the joint, Using a 1.9 mm 30 degrees ob lique arthroscope the MTP joint is inspected through dorsomedial and dorsol ateral portals with a medial portal if necessary. All patients were found t o have intra-articular pathology, which was treated using small instruments . The mean follow-up was 19.3 months (6 to 62) and all patients had no or min imal pain, decreased swelling and an increased range of movement of the aff ected joint.