Postoperative cast necessity after a lapidus arthrodesis.
BACKGROUND
The incidence of non union following a first tarsometatarsal arthrodesis (Lapidus procedure) has decreased significantly with modern techniques of minimal bone resection, meticulous bone surface preparation and rigid internal fixation. We evaluated whether a postoperative wedge shoe would increase our non-union rate.


METHODS
Nineteen adult female patients (27 feet; eight bilateral, five simultaneous) undergoing a first tarsometatarsal arthrodesis for hallux valgus associated with a hypermobile first ray or for recurrent hallux valgus were managed postoperatively by allowing them to bear weight in a wedge shoe instead of a cast. Radiographs were evaluated for signs of fusion.


RESULTS
All 27 feet went on to successful union after 6 to 24 weeks. There was one superficial wound infection and one case of recurrence of the hallux valgus.


CONCLUSIONS
Based on our results, we allow adult patients undergoing a Lapidus type procedure to be managed in a postoperative wedge shoe.
Kazzaz
Sarmad
S
Consultant Orthopaedic Surgeon, Food and Ankle Unit, Royal National Orthopaedic Hospital Stammore, Middlesex, United Kingdom.
Singh
Dishan
D
D000328:Adult; D000368:Aged; D001174:Arthrodesis; D002370:Casts, Surgical; D015331:Cohort Studies; D005260:Female; D017102:Fracture Healing; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy; D012008:Recurrence; D012189:Retrospective Studies; D012775:Shoes; D016896:Treatment Outcome; D016474:Weight-Bearing; D055815:Young Adult