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Immediate weightbearing after Lapidus arthrodesis with external fixation
1Head, Foot and Ankle Surgery, and Director, Foot and Ankle Deformity Correction Fellowship, Rubin Institute of Advanced Orthopedics, International Center for Limb Lengthening, Sinai Hospital of Baltimore, Baltimore, MD.
This study presents a novel external fixation method for Lapidus fusion, a surgery for severe hallux abductovalgus with first ray hypermobility. The technique demonstrated successful radiographic union in 90% of cases, allowing immediate weight-bearing.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Reconstruction
Background:
- Severe hallux abductovalgus with first ray hypermobility often requires metatarsal-cuneiform fusion (Lapidus procedure).
- Effective fixation is crucial for successful Lapidus fusion outcomes.
Purpose of the Study:
- To present a reliable and novel fixation method for Lapidus fusion using external fixation.
- To evaluate the clinical and radiographic outcomes of this technique.
Main Methods:
- A retrospective cohort study of 20 Lapidus fusions in 19 patients.
- Fixation was achieved using an external fixation device.
- Patients were evaluated clinically and radiographically, with assessment of pain scores and union rates.
Main Results:
- 90% of patients (18 of 20 feet) achieved radiographic union.
- Mean patient pain scores decreased significantly postoperatively (p < .001).
- The most common complication was pin tract infection (5 patients), managed with antibiotics.
Conclusions:
- Immediate weight-bearing after Lapidus fusion with external fixation is a viable treatment option.
- This novel fixation method offers a reliable approach for correcting severe hallux abductovalgus with hypermobility.
- The technique shows promising results in achieving union and improving patient pain.
