A method of preparing a metatarsophalangeal joint for fusion may involve surgically accessing the metatarsophalangeal joint and separating the metatarsal from the opposed proximal phalanx at the joint. The technique may involve preparing an end of the metatarsal and preparing an end of the opposed proximal phalanx for fusion. With or without the aid of a bone positioner, the metatarsal may be moved in one or more planes, such as the frontal and transverse planes. The proximal phalanx may also be moved in one or more planes, for example relative to the moved metatarsal. Subsequently, a bone fixation device can be applied across or through the metatarsophalangeal joint separating the metatarsal from the opposed proximal phalanx.