Rate of Nonunion after First Metatarsal-Cuneiform Arthrodesis Using Joint Curettage and Two Crossed Compression Screw Fixation: A Systematic Review

The Role of Interfragmentary Compression Screw on Union Rates and Shortening of the First Ray in Lapidus Arthrodesis: A Comparative Study

“…Nevertheless, in 6% (2/32) symptomatic pseudarthrosis occurred and revision surgery was indicated. The non-union rates observed are comparable to the rates reported in literature quoted between 5 and 12% [8,10,12,15,37]. Comparing the two modifications (IPS and EPS) of the LA no difference in union-rates could be observed.…”

A Multicenter, Retrospective Study of Early Weightbearing for Modified Lapidus Arthrodesis

“…Our results have shown that at times surgeon attention to joint preparation will be suboptimal, despite being integral to the success of the procedure. Evidence from a systematic review by Donnenwerth et al, (9) which reported a nonunion rate of approximately 5% for modified Lapidus arthrodesis using 2 crossed screws and a curettage joint preparation technique in 599 feet supports the latter. Several recent studies have reported promising data in favor of fixation to the plantar (ie, tension side) surface for modified Lapidus arthrodesis (6,7,16,20,23).…”

“…Since originally described by Albrecht (1) in 1911 and popularized by Lapidus beginning in 1934, several investigators have proposed modified techniques and/or fixation constructs in an effort to decrease the incidence of complications, including nonunion for first tarsometatarsal arthrodesis (1)(2)(3)(4)(5)(6)(7)(8)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(23)(24)(25)(26). Historically, this procedure required extensive periods of non-weightbearing to limit the risk of nonunion or other complications, such as first metatarsal elevation (1,2,5,(8)(9)(10)(11)13,15,18,19,21,22,25,26). However, the risks associated with prolonged non-weightbearing are also obvious and warrant consideration to achieve optimal patient outcomes (eg, deep vein thrombosis, disuse osteopenia, generalized deconditioning).…”

Modified Lapidus Procedure with Joint Compression, Meticulous Surface Preparation, and Shear-Strain-Relieved Bone Graft Yields Low Nonunion Rate

“…The biggest concern in previous publications is a relatively high nonunion rate, up to 12% (Table 1) [2,10,11,13,18]. However, most of these studies with high nonunion rates involved varied joint preparation and different types of fixation [2,3,7,8,10,13,16,18]. Most recently, a metaanalysis in 2011 found a nonunion rate of 5% in 537 patients and recommended further investigation [3].…”