Revision Lapidus Arthrodesis by Bone Endoscopy

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Revision Lapidus Arthrodesis by Bone Endoscopy Tun Hing Lui, M.B.B.S.(H.K.), F.R.C.S.(Edin.), F.H.K.A.M., F.H.K.C.O.S. Arthroscopy Techniques Volume 5, Issue 4, Pages e699-e704 (August 2016) DOI: 10.1016/j.eats.2016.02.029 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Revision Lapidus arthrodesis of right foot by bone endoscopy. Preoperative radiographs (A, B) and computed tomogram (C, D) of the illustrated case showed nonunion (N) of the Lapidus arthrodesis with screw loosening and associated bone cysts (BC) formation. Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Revision Lapidus arthrodesis of right foot by bone endoscopy. The obliterated distal screw hole is refreshed by a 5-mm cannulated drill along a guide pin. (a, dorsal portal incision.) Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Revision Lapidus arthrodesis of right foot by bone endoscopy. (A) Plantar portal as the viewing portal. The proximal part of the screw tract and cuneiform bone cysts are debrided. (a, dorsal portal incision.) (B) Arthroscopic view of the cuneiform bone cyst (CBC) after debridement. (PP, proximal portal.) Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Revision Lapidus arthrodesis of right foot by bone endoscopy. Plantar portal as the viewing portal. An angled arthroscopic awl is inserted through the proximal portal to the nonunion site (NS) to break down the adhesions. Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Revision Lapidus arthrodesis of right foot by bone endoscopy. (A) Dorsal portal as the viewing portal. (a, dorsal portal incision; b, plantar portal incision.) (B) The distal part of the screw tract and the metatarsal bone cyst (MBC) is debrided. Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Revision Lapidus arthrodesis of right foot by bone endoscopy. Plantar portal as the viewing portal. The subchondral bone (SB) of the nonunion site is cracked by an arthroscopic awl through the dorsal portal. Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 Revision Lapidus arthrodesis of right foot by bone endoscopy. Plantar portal as the viewing portal. Bone cyst (BC) is grafted by means of a drill sleeve through the dorsal portal. Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 8 Revision Lapidus arthrodesis of right foot by bone endoscopy. Plantar portal as the viewing portal. Nonunion site (NS) is grafted by means of a drill sleeve through the dorsal portal. Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 9 Revision Lapidus arthrodesis of right foot by bone endoscopy. After bone grafting, the nonunion site is placed in the desired position and fixed with crossed 4.0-mm cannulated screw and immobilized in a short leg cast. (A) Dorsoplantar view and (B) oblique view. Arthroscopy Techniques 2016 5, e699-e704DOI: (10.1016/j.eats.2016.02.029) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions