Surgical Reconstruction of Nonunion after Iatrogenic Scarf Osteotomy

Mercedes Ortiz-Romero, Luke D. Cicchinelli, Álvaro Fernández-Garzón and Luis M. Gordillo-Fernández
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Mercedes Ortiz-Romero: Department of Podiatry, University of Seville, 41009 Seville, Spain
Luke D. Cicchinelli: Independent Researcher, Philadelphia, PA 19107, USA
Álvaro Fernández-Garzón: Independent Researcher, 11201 Algeciras, Spain
Luis M. Gordillo-Fernández: Department of Podiatry, University of Seville, 41009 Seville, Spain

IJERPH, 2021, vol. 18, issue 11, 1-9

Abstract: We present the case of a young patient, 32 years old, with nonunion in the diaphysis of the first metatarsal after scarf osteotomy for correction of hallux valgus. After removal of the failed osteosynthesis material and preparation of the bone fragments, a calcaneal bone autograft, previously extracted from the patient, was placed in the nonunion area. The new physiological position of the first metatarsal in the three planes was checked intraoperatively, and autograft and fragment fixation was performed using a combination of a low-profile plate with six screws and two interfragmentary screws. The advantage of using an autogenous graft is that it provides corticocancellous bone and great osteogenic capacity with little antigenic capacity. This makes it an excellent option in many situations in foot and ankle surgery. Regarding the fixation method, we used the two most commonly used techniques for osteosynthesis of bone grafts in cases of bone nonunion, combining plates with locking screws and two interfragmentary screws. This provides greater stability of the bone fragments in the three planes and makes it possible to bring forward when the patient starts postsurgical loading.

Keywords: scarf; iatrogenic; nonunion; autograft; surgery; foot; orthopedics; foot pathologies; walking aid device (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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