title: Immediate weightbearing after Lapidus arthrodesis with external fixation.
abstract: A common surgical treatment of severe hallux abductovalgus deformity with coincident first ray hypermobility is metatarsal-cuneiform fusion or Lapidus procedure. The aim of the present study was to illustrate a reliable and novel method of fixation for Lapidus fusion using an external fixation device through a retrospective cohort investigation of consecutive patients. Twenty Lapidus fusions were performed in 19 patients, including 17 females (89.47%) and 2 males (10.53%). The mean age at surgery was 41 (range 20 to 64) years. The patients were evaluated clinically and radiographically pre- and postoperatively. The mean duration in the fixator was 12 (range 3 to 34) weeks. The mean interval to radiographic union was 9.2 (range 4.7 to 30.7) weeks in 18 of 20 feet (90%) and 2 (10%) were designated as nonunion. The mean follow-up period was 37 (range 5.6 to 211.1) weeks. The most common complication was pin tract infection in 5 patients (6 feet) and was treated with oral antibiotics; only 1 foot required early hardware removal. According to the visual analog scale, the mean patient pain score decreased significantly from 8.2 ± 2.7 to 0.83 ± 0.98 postoperatively (p < .001). Our results highlight that immediate weightbearing after Lapidus fusion with external fixation is a viable treatment option for the correction of severe hallux abductovalgus with associated hypermobility.
authors.affiliation: Head, Foot and Ankle Surgery, and Director, Foot and Ankle Deformity Correction Fellowship, Rubin Institute of Advanced Orthopedics, International Center for Limb Lengthening, Sinai Hospital of Baltimore, Baltimore, MD.
authors.forename: Bradley M
authors.initials: BM
authors.lastname: Lamm
authors.affiliation: Clinical Fellow, Foot and Ankle Deformity Fellowship, Rubin Institute of Advanced Orthopedics, International Center for Limb Lengthening, Sinai Hospital of Baltimore, Baltimore, MD. Electronic address: jwynes@gmail.com.
authors.forename: Jacob
authors.initials: J
authors.lastname: Wynes
mesh_terms: D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D016267:External Fixators; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D011184:Postoperative Period; D011859:Radiography; D012189:Retrospective Studies; D016474:Weight-Bearing; D055815:Young Adult
keywords: Lisfranc; bunion; fusion; hallux valgus; hypermobility; metatarsal; nonunion