Principle
A joint chosen for fusion should be positioned to maximise function and minimise compensatory stress on neighbouring joints.
Common functional positions
| Joint | Typical functional position |
|---|---|
| Shoulder | approximately 30° flexion, 30° abduction and 30° internal rotation |
| Hip | approximately 20–30° flexion, slight abduction and slight external rotation |
| Knee | slight flexion, commonly around 5–10° |
| Ankle | neutral dorsiflexion, slight valgus and slight external rotation |
| First MTP joint | dorsiflexed relative to the floor to permit toe-off, with slight valgus |
Exact position should be individualised for limb alignment, footwear and functional demands.
General principles
- correct deformity before fusion
- achieve broad viable bone contact
- provide stable compression
- preserve neighbouring joints where possible
- confirm position clinically before definitive fixation
Diagram
