Abstract
Although structural allograft has been previously described as acceptable practice
for reconstructive foot and ankle surgery, results for an allograft bone wedge in
Lapidus arthrodesis are unknown. Additionally, there is no consensus on the superiority
of a single fixation construct in Lapidus cases. Our objective was (1) to report union
rates for Lapidus arthrodesis with and without the use of an allograft bone wedge
and (2) to determine if fixation construct impacts rates of union when using structural
allograft. A review was performed for Lapidus cases with fixation constructs of 2
crossed compression screws (CS) and a medial locking plate with single transarticular
screw (MPS), both with and without use of an allograft bone wedge. Inclusion required
a CT scan to evaluate bony union. There was no significant difference in union rates
(p = .41) between the use (90%) and the nonuse (97%) of an allograft bone wedge. Union
rates were significantly different (p = .04) when comparing CS fixation (85%) and MPS fixation (98%). The comparative results
between the fixation constructs highlight the importance of compression across the
arthrodesis site as part of a robust fixation construct. Our findings demonstrate
that the use of an allograft bone wedge in Lapidus arthrodesis may mitigate complications
due to metatarsal shortening while providing satisfactory rates of union.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: May 21, 2022
Footnotes
Financial Disclosure: This work was supported by a grant (# IIR-202007-02) obtained from Paragon 28.
Conflict of Interest: The authors declare that funding was obtained from Paragon 28; TSG declares a relationship with Paragon 28 including speaker's bureau and consultation.
Institutional Board Review: IRB Baptist Health: #1823209-1.
Identification
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
