From the Research
Yes, a person can function well long-term with an asymptomatic nonunion after Lapidus surgery, which fuses the first metatarsocuneiform joint to correct bunions. If the nonunion (failure of the bones to completely heal together) is not causing pain or instability, many patients can maintain normal activities without additional treatment. The key factor is whether the nonunion is symptomatic or asymptomatic. Asymptomatic nonunions often develop sufficient fibrous tissue between the bone ends to provide stability, allowing for normal weight-bearing and function. However, patients should maintain regular follow-up with their foot surgeon to monitor for any changes, as some asymptomatic nonunions may eventually become painful or problematic.
According to a study published in 2021 1, teriparatide has been found to induce union in those with delayed union and nonunion, with a high success rate of 95.3% in achieving complete union. However, this treatment option is typically considered for symptomatic nonunions. For asymptomatic nonunions, the focus is on monitoring and maintaining a healthy lifestyle to reduce the risk of complications.
Some key points to consider for patients with asymptomatic nonunions after Lapidus surgery include:
- Avoiding high-impact activities that could stress the nonunion site
- Reporting any new pain, swelling, or mobility changes to their doctor promptly
- Maintaining regular follow-up with their foot surgeon to monitor for any changes
- Weight management to reduce stress on the foot
- Considering treatment options such as bone stimulation devices, revision surgery with bone grafting, or hardware adjustments if pain develops.
It's also important to note that smoking has been found to be a predictor of nonunion in some studies, such as the one published in 2007 2. Therefore, smoking cessation is highly recommended for patients who have undergone Lapidus surgery.
Overall, while asymptomatic nonunions after Lapidus surgery can be managed conservatively, it's essential for patients to be aware of the potential risks and complications and to maintain regular follow-up with their foot surgeon to ensure the best possible outcome.