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.