A novel technique used in a small series of patients is presented that describes a management option for the difficult situation of hallux metatarsophalangeal pathology with associated first-ray shortening and transfer lesions. Distraction arthrodesis was performed using proximal tibial cancellous autograft and locked plating to achieve an average of 10.6 mm length restoration with all patients showing radiographic signs of union by the eighth postoperative week and resolution of transfer metatarsalgia. This novel technique shows promise for reliable outcomes in a variety of historically difficult clinical situations such as inflammatory arthritis and salvage arthrodesis.
Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.