Cuneiform cartilages

Surgical Pearls to Decrease Non-Union in the Lapidus Procedure for the Correction of Large Unstable Bunion Deformity: Tarsal Joint Distractor The Lapidus Procedure has certainly undergone a resurgence in popularity in recent years for the correction of severe and unstable bunion deformities. Although fusion of the first met cuneiform joint can afford the surgeon the ability to easily correct a large bunion deformity or one with a component of first ray instability, it is critical that adequate joint preparation is performed in order to achieve a successful result. The most difficult part about this procedure is gaining access to the plantar aspect of the joint. Because of the depth and kidney bean-shaped curvature of the first metatarsocuneiform joint, it can be very challenging to reach the plantar-most section of the articular surface. The easiest way to open the fully joint the open and access the plantarlateral corner of the first met cuneiform joint is to use two k-wires applied on either side of the joint. Simply place one k-wire in the body of the medial cuneiform and one in the base of the first metatarsal. The Tarsal Joint Distractor can then be placed over these k-wires and used to retract the first metatarsocuneiform joint. Now by simply cranking the Tarsal Joint Distractor open, you have clear stable access the the articular surfaces. With the first met-cuneiform joint held open in this retracted position, you may then perform your joint preparation. If you <b>...</b>