A shortened first metatarsophalangeal joint (MTPJ) fusion can be a debilitating complication of arthrodesis surgery. The most commonly accepted treatment is revision of the first MTPJ revisional arthrodesis with lengthening utilizing bone graft. To our knowledge, there is no published literature on first MTPJ short malunion correction using monorail distraction and arthroplasty with a silastic implant. A case is presented of a young active 32-year-old individual who presented to our office following a first MPJ arthrodesis and first tarsometatarsal joint (TMTJ) arthrodesis with severe shortening of the metatarsal. The patient underwent a two-stage procedure consisting of a fusion take down with external monorail distraction fixator, followed by first MTPJ arthroplasty with a silastic implant.

Subtalar joint ligament sprains are often missed in the setting of chronic inversion ankle injuries. This can lead to pain and instability of the subtalar joint. In many cases, without proper identification, the patient may eventually undergo an unnecessary subtalar joint fusion rather than a ligament reconstruction. Achilles, peroneus brevis, and gracilis tendon grafts have been described to repair subtalar ligament instability in the literature. To our knowledge, the use of exogenous ligament repair technique using nonabsorbable suture made of Ultra High Molecular Weight Polyethylene (UHMWPE) and suture anchors has not been described for subtalar joint stabilization. Here we present a case of 17-year-old female who underwent subtalar joint stabilization with a suture anchor construct for bilateral chronic subtalar joint instability.