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The Incidence of Nonunion after Lapidus Arthrodesis Using Staple Fixation

2014; Elsevier BV; Volume: 53; Issue: 3 Linguagem: Inglês

10.1053/j.jfas.2013.09.004

1542-2224

Jason P. Mallette, Courtney L. Glenn, Douglas J. Glod,

Lower Extremity Biomechanics and Pathologies

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.