Failure of Fixation With Nickel–Titanium Staples in First Metatarsophalangeal Arthrodesis With Hallux Valgus Deformity

First metatarsophalangeal (MTP) joint arthrodesis is a treatment option for patients with arthritic hallux valgus (HV). Nickel–titanium staples allow continuous compression throughout the fusion site and have been shown to achieve successful union in many procedures. However, their efficacy has not been tested in patients with underlying HV deformity. Three cases of severe HV deformity that underwent first MTP arthrodesis with 2 nickel–titanium staples placed 60° from each other and had failure are reported. The authors believe this construct does not provide adequate rotational control for first MTP arthrodesis in patients with severe HV deformity. [First metatarsophalangeal (MTP) joint arthrodesis is a treatment option for patients with arthritic hallux valgus (HV). Nickel–titanium staples allow continuous compression throughout the fusion site and have been shown to achieve successful union in many procedures. However, their efficacy has not been tested in patients with underlying HV deformity. Three cases of severe HV deformity that underwent first MTP arthrodesis with 2 nickel–titanium staples placed 60° from each other and had failure are reported. The authors believe this construct does not provide adequate rotational control for first MTP arthrodesis in patients with severe HV deformity. [Orthopedics. 2019; 42(4):e402–e404.]