title: The incidence of nonunion after Lapidus arthrodesis using staple fixation.
abstract: Today's foot and ankle surgeon has multiple options when choosing a fixation device for Lapidus arthrodesis, many of which have well-documented nonunion rates. The present study aimed to fill a void in the current foot and ankle literature by establishing a nonunion rate for staple fixation for the Lapidus procedure. The present retrospective analysis of the medical record focused on nickel-titanium staples that were inserted in a delta configuration to yield a stable construct for first metatarsal-cuneiform fusion. The patients were kept strictly non-weightbearing for the first 6 weeks postoperatively. Weightbearing progressed at that point according to the radiographic findings of each case. The data from 35 consecutive patients were analyzed (25 females, 10 males; mean age 43.1 [range 15 to 72] years in whom a Lapidus arthrodesis was performed using staple fixation in 36 feet. The patients were followed until fusion was noted and pain had resolved. Pain resolution occurred at 6 weeks in the earliest cases and several years in others. The incidence of nonunion was 3 (8.3%) of 36 when staple fixation was used for first metatarsal-medial cuneiform arthrodesis.
authors.affiliation: Private Practice, South County Foot and Ankle, Warwick, RI. Electronic address: jmallette@scfaa.com.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Mallette
authors.affiliation: Postgraduate Year 1 Resident, Residency Program, Memorial Hospital of Rhode Island, Pawtucket, RI.
authors.forename: Courtney L
authors.initials: CL
authors.lastname: Glenn
authors.affiliation: Chief, Department of Podiatry, and Director, Residency Program, Memorial Hospital of Rhode Island, Pawtucket, RI.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Glod
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000009:adverse effects*; D005260:Female; D005530:Foot Deformities / Q000000981:diagnostic imaging / Q000601:surgery*; D005599:Fractures, Ununited / Q000209:etiology; D006214:Hallux / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D017792:Surgical Stapling; D055815:Young Adult
keywords: bunionectomy; complication; hallux abductovalgus; internal fixation; memory metal; metatarsocuneiform arthrodesis