Return to Physical Activity and Footwear Modifications After First Metatarsophalangeal Joint Arthrodesis, Including Alpine Sports: A Retrospective Case Series

Background: First metatarsophalangeal (MTP) arthrodesis can effectively alleviate pain and correct deformity of the great toe but may introduce unique limitations to an active patient population, particularly in alpine-specific sports including Nordic and alpine skiing, snowboarding, hiking, trail running and biking. Limited literature evaluates return to these specific activities after first-MTP arthrodesis. This study aims to better define the ability to return to physical activity, with a focus on alpine sports and footwear modifications. Methods: Adults undergoing MTP arthrodesis with ≥1-year follow-up at a single academic institution were retrospectively reviewed. Demographic data, surgical complications, and radiographic union were recorded. A custom sports questionnaire was administered preoperatively and postoperatively across >20 sports, including outdoor and alpine sports, to assess return to activity. Paired t tests compared pre- to postoperative changes in patient-reported outcomes, with significance set to P