Lapidus procedure-stabilising K wire
A stabilising K wire is inserted initially(1).Metatarsus Varus should be corrected, neutral rotation
and adequate plantar flexion of the metatarsal also accomodated.With a 5mm high speed burr a dorsal trough is removed from the first metatarsal cortex. Without this the screw head will impinge upon the dorsal cortex and prevent compression. This should be a few cm distal to the joint line to avoid fracturing into the joint as the screw is driven home.