Pertinent Insights On Treating Lapidus Nonunions

Start Page: 36
By Graham A. Hamilton, DPM

In Conclusion

     With the emergence of newer surgical techniques and implants, there is a relatively low incidence of nonunion after a primary Lapidus arthrodesis. However, despite these technological advances, nonunions do occur and can be very challenging to remedy. In our analysis of 17 patients revised with autogenous bone graft and internal fixation, we were able to demonstrate a favorable rate of union (82 percent).

     Noncompliance in the postoperative course and cigarette smoking were both associated with increased rates of nonunion, with the latter proving statistically significant. Strict patient counseling in the preoperative period to support compliance is strongly recommended. Also, one should view active cigarette smoking as a relative contraindication to revision.

Dr. Hamilton is the Director of Research at the San Francisco Bay Area Foot and Ankle Residency Program. He is a Fellow of the American College of Foot and Ankle Surgeons.
Dr. Burks is a Fellow of the American College of Foot and Ankle Surgeons, and is board certified in foot and ankle surgery. Dr. Burks practices in Little Rock, Ark.


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