Clinical question: How can a conical reamer be used to guide accurate wire placement when preparing the first metatarsal head for first metatarsophalangeal joint fusion?
First MTP Joint Fusion: Using a Conical Reamer to Guide Wire Placement
Asim Raja, DPM, FACFAS
In this In the Lab with AO NA episode, Asim Raja, DPM, FACFAS, demonstrates a practical technique for preparing the metatarsal head during first metatarsophalangeal (MTP) joint fusion. Instead of placing the guide wire first, Dr. Raja selects and positions the appropriately sized conical reamer over the metatarsal head, then uses the reamer itself as a guide for wire placement—helping establish the intended reamer position before joint preparation.
