I performed a McBride/Lapidus on a 48-year-old female runner approximately 10 weeks ago. She had a hypermobile,severe bunion, that was not amenable to a head procedure.
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Intraoperatively, she had significant DJD at the plantar sesamoidal grooves however nothing more than I would normally see with this sort of deformity. Otherwise, nothing unusual was noted. Obviously, great care was taken intra-operatively due to her activity level.
Now at 10 weeks, the fusion site is doing very well however she has no sign of hallux extension. It appears the muscle is firing as I can see EHL tendon tensioning proximal to surgery site however the tendon" disappears" along the surgery site. It's acting like a transected tendon. Puzzling.
I have ordered an MRI and hope this will help clarify (although fixation may complicate this matter).
Has anyone had this experience and any suggestions as to the possible etiology?
Additionally, she has significant amount of first MTP stiffness and having difficulty recruiting the flexor hallucis tendon.
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