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Avascular Necrosis of the First Metatarsal: A Case of Second Metatarsal Bone Transport with External Fixation
Bradley M Lamm1, Kyle R Moore2, Matthew Hentges3
1Chief of Foot & Ankle Surgery, Director, Foot & Ankle Deformity Center, Director, Foot & Ankle Deformity Correction Fellowship, The Paley Institute at St. Mary's Medical Center and Palm Beach Children's Hospital, West Palm Beach, FL.
Abstract:
Avascular necrosis (AVN) after bunion surgery is an unfortunate complication which can be devastating and painful. We present a case report of gradual medializing transport of the second metatarsal with external fixation to repair a large bone defect caused by AVN affecting >50% of the first metatarsal. The procedure was performed on a 49-year-old female who suffered AVN after failed bunion surgery. At 12-month follow up, first ray position and length were maintained. With respect to the second ray, there were no clinically significant issues. The second digit was mildly elevated but there was no frank instability of the toe or of the Lisfranc complex. The patient was pain free and had returned to her desired daily activities.
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