Bunions: Correction With Lapidus Plate Fusion

Bunions: Correction With Lapidus Plate Fusion

This video demonstrates the surgical repair of a bunion, utilizing a joint fusion with a plate and screws. The procedure will be demonstrated on a live patient.

The surgeon will make an incision on the inside, or medial side, of the foot, overlying the first tarsal metatarsal joint. This joint is often called the first T M T joint. This is the joint the surgeon will be fusing to correct the bunion deformity.

Once the incision is made, a soft tissue retractor will be used to help the surgeon visualize the surgical area. There is an important tendon the surgeon will identify and protect. A small portion of the tendon must be removed from the bone to expose the joint, but most of the tendon stays attached.

The surgeon has placed 2 small wires in each bone of the joint and an instrument to help open the joint. An instrument called a rasp will be used to shave off the thin cartilage at the end of each bone. This thin protective layer is removed so that the bones can heal together over the following weeks.

Bone graft is being placed in the joint to assist with healing. If there is additional deformity in the metatarsal bone, a temporary wire will be placed into the bone to help move it into proper position. A clamp will also be used for additional support.

The plate will be placed on the bottom of the joint. Temporary wires will be used to hold the plate to the bone. Here, you see the prepared fusion site and the protected tendon. Before screws are placed, x-rays will be taken to ensure the plate is in the proper position.

A drill tower will be placed, and a drill will be used to make a hole for the first screw. Here, the first screw is being placed. One wire will be removed, and again this process will be repeated to place another screw. A larger drill and screw will be used across the joint space to assist with the fusion.

Here you see an x-ray of the drill going across the fusion site. The length of the hole will be measured, and a screw will be inserted partially. The temporary wires will be removed. The surgeon then inserts the rest of the screw and the fusion site compresses.

The final screws will be inserted. Here is the final x-ray of the plate, the fusion site, and corrected bunion deformity. The incision is closed, and a dressing is placed. The surgery is now complete.