Postoperative cast necessity after a lapidus arthrodesis.

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery

Background:

• The Lapidus procedure (first tarsometatarsal arthrodesis) is a common surgical treatment for hallux valgus.
• Modern techniques have reduced non-union rates, but postoperative management remains crucial.

Purpose of the Study:

• To evaluate the safety and efficacy of using a postoperative wedge shoe instead of a cast for patients undergoing a Lapidus procedure.
• To determine if this management strategy impacts the non-union rate.

Main Methods:

• A retrospective review of 19 adult female patients (27 feet) who underwent a first tarsometatarsal arthrodesis.
• Patients were allowed to bear weight in a wedge shoe postoperatively, avoiding traditional casting.
• Radiographic evaluation was used to assess bone fusion.

Main Results:

• All 27 feet achieved successful bony union within 6 to 24 weeks.
• One patient experienced a superficial wound infection, and another had a recurrence of hallux valgus.
• No non-unions were reported in the cohort managed with wedge shoes.

Conclusions:

• Managing patients in a postoperative wedge shoe after a Lapidus procedure is a viable option.
• This approach did not compromise bone fusion and may offer an alternative to casting.