Totally implanted direct current stimulator as treatment for a nonunion in the foot

Nonunions and delayed unions are postoperative complications with which the podiatric surgeon must be concerned. Although the incidence is infrequent, their treatment methods vary, and can range from bone grafting to internal and external fixation of fragments, arthrodesis, and/or the use of indirect and direct bone stimulation. This manuscript details a case of a nonunion of the first metatarsal cuneiform joint 8 months after attempted Lisfranc's joint fusion for Charcot arthropathy of the midfoot. The nonunion was treated with bone grafting, internal fixation, and the use of an implanted direct current bone stimulator. Although implanted bone stimulators are commonly used for the treatment of failed unions of the posterior spine, tibia, and humerus, to date, the authors submit this is the first reported case of implementing a totally implanted direct current stimulator for treatment of a nonunion in the foot.