Roukis TS: Nonunion after arthrodesis of the first metatarsal-phalangeal joint: a systematic review. J Foot Ankle Surg 50: 710, 2011.
Roukis TS: First metatarsal-phalangeal arthrodesis: primary, revision, and salvage of complications. Clin Podiatr Med Surg 34: 301, 2017.
Hamilton GA, Ford LA, Patel S: First metatarsophalangeal joint arthrodesis and revision arthrodesis. Clin Podiatr Med Surg 26: 459, 2009.
Bennett GL, Sabetta J: First metatarsalphalangeal joint arthrodesis: evaluation of plate and screw fixation. Foot Ankle Int 30: 752, 2009.
Bennett GL, Kay DB, Sabatta J: First metatarsophalangeal joint arthrodesis: an evaluation of hardware failure. Foot Ankle Int 26: 593, 2005.
Politi J, John H, Njus G, et al.: First metatarsal-phalangeal joint arthrodesis: a biomechanical assessment of stability. Foot Ankle Int 24: 332, 2003.
Martone J, Poel LV, Levy N: Complications of arthrodesis and nonunion. Clin Podiatr Med Surg 29: 11, 2012.
McGlamry ED: “Nonunions,” in McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery, Vol 2, edited by JT Southerland, p 1309, Philadelphia, Lippincott Williams & Wilkins, 2013.
Shibuya N, Humphers JM, Fluhman BL, et al.: Factors associated with nonunion, delayed union, and malunion in foot and ankle surgery in diabetic patients. J Foot Ankle Surg 52: 207, 2013.
Rupp M, Kern S, Weber T, et al.: Polymicrobial infections and microbial patterns in infected nonunions—a descriptive analysis of 42 cases. BMC Infect Dis 20: 667, 2020.
Lew DP, Waldvogel FA: Osteomyelitis. N Engl J Med 336: 999, 1997.
Thevendran G, Younger A, Pinney S: Current concepts review: risk factors for nonunions in foot and ankle arthrodeses. Foot Ankle Int 33: 1031, 2012.
Keramaris NC, Calori GM, Nikolaou VS, et al.: Fracture vascularity and bone healing: a systematic review of the role of VEGF. Injury 39(suppl 2): 45, 2008.
Thevendran G, Shah K, Pinney SJ, et al.: Perceived risk factors for nonunion following foot and ankle arthrodesis. J Orthop Surg (Hong Kong) 25: 2309499017692703, 2017.
Shyam A, Sancheti PK, Patel SK, et al.: Use of antibiotic cement-impregnated intramedullary nail in treatment of infected non-union of long bones. Indian J Orthop 43: 396, 2009.
Treadwell JR: First metatarsophalangeal joint arthrodesis; what is the best fixation option? A critical review of the literature. Clin Podiatr Med Surg 30: 327, 2013.
Cobb TK, Gabrielsen TA, Campbell DC II, et al.: Cigarette smoking and nonunion after ankle arthrodesis. Foot Ankle Int 15: 64, 1994.
A 55-year-old woman with a complicated infected nonunion after first metatarsophalangeal joint arthrodesis is presented. The patient initially underwent cross-screw fixation for the treatment of hallux rigidus that resulted in joint infection and hardware loosening. A staged surgical approach was undertaken by means of initial hardware removal with implementation of an antibiotic cement spacer followed by revision arthrodesis with interposition of tricortical iliac crest autograft. This case report aims to highlight an accepted surgical approach to address an infected nonunion at the level of the first metatarsophalangeal joint.