50 cases of first metatarsophalangeal joint fusion in 32 patients were carried out using the AO tension band wire. There were 28 females and 4 males with an average age of 51.6 years. 43 operations were for hallux valgus and 7 were for hallux rigidus. The average postoperative reduction in the hallux valgus angle was 52.6% (from 32.7 o to 15.5 o ). The average postoperative reduction in the intermetatarsal angle was 24.3% (13.1 o to 9.9 o ). A total of 26 patients (81.6%) were satisfied with the results of surgery. Problems due to prominent or broken wires occurring in 13 feet (26%) seemed to be a major cause of complaint. Although non-union was detected in 19 feet (38%), a large proportion of these patients (12 out of these 19 feet) were asymptomatic.Our study showed that AO tension band wire is effective in maintaining a satisfactory toe position in first MP joint fusion. It is however not a reliable device for achieving sound bony fusion of the first MP joint, as evidenced by the high rate of nonunion. A perfect flat cut surface of the opposing bone in correct plane is required to achieve bony fusion. This technically has a learning curve.