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The response to the question below was authored by Marc Mitnick DPM

6 months post-op lapidus with a non-union

by Pam
(Frisco, TX, USA)

I have a non-union from a lapidus done 6 months ago. I was given an Ortho-fix bone stimulator (3hrs/day application) at month 5 and told to decrease my activity and put the boot back on. Now one month later, there is no difference on X-ray in the non-union. My question is--is it too soon to see any bone growth (Ortho-fix rep said it takes 3-9 months)? Also, my new ortho surgeon states that, even though the foot is stable but moderately painful, a revision with a bone graft is indicated. Any thoughts?

thank you
Pam

ANSWER

Hi Pam,

Keep in mind I am making the following statements without having seen your post op x-ray, meaning I do not know the degree of non-union.
In general it will take a few months for the bone stimulator to do its magic, if it is going to work. Over the years I have seen some amazing results with bone stimulators, I can recall an instance with a fifth metatarsal fracture that have a propensity not to heal, actually close through the use of a bone stimulator.
The problem becomes one of how long do you want to wait to see if the non-union will actually close or not.
If the thought of waiting nine months is better than the idea of more surgery you should wait, keeping in mind that you may still have to have a bone graft.
If you have a busy schedule and cannot or do not want to wait it out, then you should talk to your surgeon about the bone graft.
Not only do you have to be diligent about using the bone stimulator, but you have to be serious about reducing your activity, wearing the cast or boot, all the time; no cheating. Additionally, if you smoke that reduces the chances of a bone union. I do not know your age, but that can be an issue as well.
As you can see it becomes an issue, in my mind, about the quality of your life while you are trying resolve this issue.

Marc Mitnick DPM
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American Family Physician

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6 months post-op lapidus with a non-union

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