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Updated: Jan 25, 2026
Fabrication of Myogenic Engineered Tissue Constructs
Published on: May 1, 2009
IOFix™ with plate construct is similar to locking plate construct for Lapidus bunionectomy procedure outcomes
Amol Saxena1, Todd O'Brien2, Miranda Royds3
1BASS Medical Group, Palo Alto, CA, United States.
Background:
The Lapidus bunionectomy has evolved with advanced fixation constructs since its first description. These new techniques have aimed to reduce complications such as non-union or hardware related symptoms. The IOFix™ system, an intramedullary device that has been designed to enhance stability and compression, may offer outcomes that are comparable to traditional medial locking plate with lag screw constructs.
Purpose:
To compare outcomes of the Lapidus bunionectomy using the IOFix™ and plate construct versus a traditional medial locking plate with a plantar lag screw.
Methods:
This IRB-approved retrospective case-control study reviewed 46 patients (23 per cohort) treated by a single surgeon between 2014 and 2022, with minimum 24-month follow-up. Patients underwent Lapidus bunionectomy using either an IOFix™ and dorsal plate (intervention) or a locking plate with plantar lag screw (control). Outcome measures included incidence of non-union, hardware removal, loss of correction (1st IMA >8° or HAA >20°), and AOFAS Hallux scores. Statistical analysis used two-tailed t-tests and Fisher's exact test with significance set at P < 0.05.
Results:
All cases in both IOFix™ and locking plate groups achieved a union rate of 100 %. There were no reported infections, non-unions, or revision surgeries in either cohort. Hardware removal rates were not significantly different between IOFix™ (26 %) and control (13 %) groups (P = 0.46), and only the dorsal plates were removed. There were no reported cases of removal of the IOFix™ device. AOFAS scores improved significantly in both groups post-operatively (P < 0.0001), with no significant difference between groups pre- or post-operatively. There were no significant differences in demographic data, loss of correction, or complication rates between groups.
Conclusion:
The IOFix™ and dorsal plate construct offers comparable outcomes to traditional locking plate with lag screw fixation in the Lapidus bunionectomy, with similar union rates, clinical outcomes, and hardware-related complications. These findings suggest that IOFix™ is an effective alternative fixation method. Further studies with larger sample sizes and long-term follow-up are warranted.
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