Chronic Edema Research Articles

Kronik Alt Ekstremite Ödemi Olan Hastalarda Sakroiliyak Eklem Disfonksiyonu Varlığı ve Postür Analizi

Abstract
 Background and Aim: Chronic lower extremity edema has been associated with postural impairment, sacroiliac joint dysfunction (SIJD), and abnormal gait. Lymphedema and lipedema are important chronic lower extremity causes. This study aimed to detect the presence of SIJD and postural disorders in patients with lower extremity edema and the relationship between them.
 Methods: This is a comparative, prospective cohort study. Fifty-three patients with lower extremity edema and 53 healthy subjects were included in the study. Pain provocation tests were used to determine SIJD. Postural analysis was conducted with PostureScreen® Mobile 11.2 (PostureCo, Inc., Trinity, FL) software. The life quality of participants was determined by the Lymphedema Quality of Life (LYMQOL) scale. The functional status of the patients was determined by the Oswestry Disability Index and Lower Extremity Functional Scale.
 Results: SIJD (18.9%) was more common in the edema group. There was a positive correlation between volume differences, percentages, and the development of SIJD. We found deviations in the head, shoulder, and hip angulations in the edema group. Q angle and lateral shoulder angulation were significantly higher in patients with SIJD in the edema group. In the edema group, LYMQOL-leg total score was higher in patients with SIJD.
 Conclusion: Chronic lower extremity edema was found to be associated with postural deviations and SIJD. Besides edema control, postural disorders and SIJD should also be considered in these patients.

Efficacy of 190 mcg fluocinolone acetonide intravitreal implant: microperimetry and OCT real-life data.

Fluocinolone acetonide is a valid alternative treatment for patients with chronic diabetic macular edema (DME) with poor response to anti-vascular endothelial growth factor (VEGF) therapy. The purpose of this study is to report the efficacy and safety of ILUVIEN® implant in pseudophakic eyes with persistent DME. This is a single-centre pilot-study of 8 patients with persistent DME treated with the ILUVIEN implant, despite previous anti-vascular endothelial growth factor and/or steroid treatment. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT) central retinal thickness, intraocular pressure (IOP) and microperimetric data were evaluated at baseline and month 1, 3 and 6 post treatment. All data are presented as mean and standard deviation. At baseline, 1, 3 and 6 months, we had BCVA of 0.26±0.22, 0.38±0.27, 0.48±0.27 and 0.46±0.24; IOP of 15.00±2.67, 15.50±3.16, 14.88±2.42 and 15.63±2.67 mmHg; macular thickness of 652±231, 487±278, 475±287 and 413±211 µm; macular sensitivity of 6.83±4.20, 6.13±3.72, 7.68±3.40 and 7.71±3.33 dB; bivariate contour elliptic area (BCEA) 95.4% 3.8±3.42, 6.06±10.06, 3.05±2.46 and 2.59±2.19°2. According to the results of our study, fluocinolone acetonide (FAc) is a valid therapy option despite some limitations. It has been evidenced that FAc is more effective in patients with mild central macular thickening, while in those with modest to severe central macular thickness (CMT), different therapy strategies should be considered.

Comparison of Semen Aesculi species from different geographical origins and horse chestnut based on metabolomics and chemometrics analysis.

Semen Aesculi, a traditional Chinese herbal medicine, has a long history of use for treating chest and abdominal pain with distension. In addition, the horse chestnut (Aesculus hippocastanum L.) is another species of Aesculus in Europe and has notable clinical significance in alleviating chronic venous insufficiency, hemorrhoids, and postoperative edema. Thus, highlighting the comparative study of Semen Aesculi and horse chestnut may broaden clinical applications. To conduct a comprehensive comparative analysis on the chemical profiling of these two varieties and determine whether they have equivalent clinical efficacy by integrating plant metabolomics and multivariate statistical methods. Initially, a comprehensive characterisation was performed using ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry (UPLC-QTOF-MS/MS) platform, and in total 44 active ingredients were identified. Then, untargeted metabolomics combined with principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) was applied for the discrimination of a German species and three official Chinese species. Next, 24 marker compounds responsible for the discrimination of different species were screened out and used to predict the species of unknown samples by genetic algorithm-optimised support vector machine (GA-SVM) with a high prediction accuracy. Finally, a heatmap visualisation was employed for clarifying the distribution of the identified active ingredients. The three species of Chinese Semen Aesculi showed distinct separation from each other, while European horse chestnut and Aesculus chinensis Bunge were similar in chemical composition. This work provided experimental evidence for further expanding the clinical application of Chinese Semen Aesculi and promoted the species identification and quality control of Semen Aesculi.

Classification and nomenclature of current materials for compression therapy

Compression therapy has been an essential part of conservative therapy for people with chronic wounds and edema of the lower extremities for hundreds of years. The initiated therapy can be divided into the decongestion phase, maintenance phase, and prevention. The choice of the respective compression materials is based, among other factors, on these phases, the clinical stage and symptoms, the needs of the affected person and their physical abilities. Today, awide range of different materials and methods are available for compression therapy. Thus, it is increasingly difficult to keep an overview of these treatment options, especially since the nomenclature used by the manufacturers is often inconsistent. Thus, the materials and methods for compression therapy currently available in German-speaking countries and their clinical indications are described in this review article. In addition, auniform nomenclature is proposed, on the basis of which an appropriate exchange between all those involved in the care of people with compression therapy is guaranteed.

Skincare for chronic oedema and lymphoedema patients

British Journal of Community NursingVol. 28, No. 2 ProfessionalSkincare for chronic oedema and lymphoedema patientsSarah Jane PalmerSarah Jane PalmerE-mail Address: [email protected]Registered nurse and freelance writer, based at the Department of Work and Pensions as a disability analystSearch for more papers by this authorSarah Jane PalmerPublished Online:3 Feb 2023https://doi.org/10.12968/bjcn.2023.28.2.84AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Fife CE, Farrow W, Hebert AA, Armer NC, Stewart BR, Cormier JN, Armer JM. Skin and Wound Care in Lymphedema Patients: A Taxonomy, Primer, and Literature Review. Adv Skin Wound Care. 2017; 30(7):305-318. https://doi.org/10.1097/01.asw.0000520501.23702.82 Crossref, Medline, Google ScholarLymphodema Scotland. Management of chronic oedema and lymphoedema. 2020. https://www.lymphoedema-scotland.org/community-nurses/management-of-chronic-oedema/ (accessed 9 February 2022) Google ScholarMarie Curie. Fluid build-up: oedema, lymphoedema and ascites. 2021. https://www.mariecurie.org.uk/professionals/palliative-care-knowledge-zone/symptom-control/lymphoedema#cellulitis (accessed 9 February 2022) Google ScholarThe British Medical Journal. Best practice lymphoedema. 2022. https://bestpractice.bmj.com/topics/en-gb/610#:~:text=Summary,disruption%20of%20the%20lymphatic%20system (accessed 9 February 2022) Google Scholar FiguresReferencesRelatedDetails 2 February 2023Volume 28Issue 2ISSN (print): 1462-4753ISSN (online): 2052-2215 Metrics History Published online 3 February 2023 Published in print 2 February 2023 Information© MA Healthcare LimitedPDF download

Case Report: Fuchs Dystrophy after Corneal Transplantation

Fuchs Endothelial Corneal Dystrophy (FECD) consists of a progressive loss of corneal endothelial cells, with subsequent development of subepithelial connective tissue objectively leading to severely impaired vision. Generally, the time interval between the asymptomatic stage, with only the presence of guttates on biomicroscopy, to the most advanced stage, associated with chronic edema that causes corneal opacity and scarring, can vary between 20 to 30 years of evolution. Eye bank donor cornea selection includes FECD screening based on macroscopic and specular microscopyfindings. However, this screening may not be sensible enough to detect the disease in its earlier stages. We report 2 cases of FECD in corneal grafts in which the donor corneas eye bank screening was negative for FECD. These two cases highlight the importance of a meticulous evaluation of donor corneas candidates for corneal transplant. Traditional evaluation was not sensible enough to detect early phases of FECD. Additional screening methods, such as genetic testing, would improve the accuracy to detect FECD and other diseases present in donor corneas used in corneal transplants.

Ruthenium brachytherapy for iris melanoma.

The study aimed to review the long-term outcomes of ruthenium brachytherapy for iris and iridociliary melanoma. Medical records of patients who underwent ruthenium plaque treatment for iris and iridociliary melanoma at the Department of Ophthalmology, Poznań University of Medical Sciences, between 1999 and 2021 were retrospectively reviewed. We identified 24 patients, including 17 women and 7 men, with a median age of 61.5 years (range, 35-84 years). Median observation time before treatment was 3 months (range, 0-68 months). Nineteen (79%) patients received a treatment with 20 mm CCB plaque, 5 (21%) with 15 mm CCA plaque and 2 (8%) patients received total irradiation to the entire iridocorneal angle. Median follow-up was 67.5 months (range, 24-265 months). We noted one (4%) recurrence managed by irradiating the anterior segment. Twelve (50%) patients developed post-operative cataracts in a median time of 38 months following treatment, 5 (21%) required topical medications to control intraocular pressure, and one (4%) developed chronic macular edema (CME) that was managed with anti-VEGF therapy. Final visual acuity between 1.0 and 0.5 was observed for 16 (67%) patients, between 0.49-0.1 for 5 (21%) patients, and below 0.09 for 3 (12%) patients. Nine (37%) patients maintained final visual acuity stable; in 4 (17%) patients, it dropped more than 3 lines, and improved in 6 (25%) patients. Ruthenium brachytherapy with standard applicators is an effective and safe way of treatment for iris and iridociliary melanoma. We observed no significant post-operative complications in a long-term observation.

Retinal veno-venous anastomosis in chronic branch retinal vein occlusion: when natural healing takes place

It was a 63-year-old woman with a positive history of systemic hypertension consulting for a three years history of blurred vision Oculus Dexter (OD). She noticed a slowly progressive spontaneous improvement and denied any previous ophtalmology consultation. Best-corrected visual acuity was 6/18 OD with unremarkabale adnexal and anterior segment examination. Fundus examination showed showing supero-tempral branch retinal vein occlusion with arterio-venous nicking, macular exudates, and numerous retinal venovenous anastomoses bridging the horizontal raphe temporally. The fellow eye was normal. We ordered a fluorescein angiography with color and monochromatic photography that highlighted the previous findings and showed macular diffusion in early and late phases (A,B,C,D). We retained the diagnosis of retinal venovenous anastomosis in chronic branch retinal vein occlusion with chronic macular edema. The patient preferred observation of her condition and refused further investigations or interventions. After two years of follow-up, her visual acuity was stable. We insisted on medical control of her systemic hypertension.

Posterior sub-Tenon triamcinolone injection in the treatment of postoperative cystoid macular edema secondary to pars plana vitrectomy.

To evaluate the efficacy and safety of posterior sub-Tenon triamcinolone (PSTA) in chronic postoperative cystoid macular edema (PCME) after pars plana vitrectomy (PPV). Consecutive 22 patients who developed chronic PCME after PPV and underwent PSTA treatment were included in this retrospective study. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured pre injection and post injection at one month, three months, six months, and at last visit. The patients were divided into three groups according to the injection response status: complete, partial, and resistant. The mean follow-up period was 26.4 ± 16.2 months after PSTA. According to pre-injection values, there was a significant improvement in the values of BCVA and CMT at the first, third, and sixth months and at the last examination (P < 0.05). In the final examination, PCME recovered completely in 12 patients, partially in 8 patients, and resistance was observed in 2 patients. Posterior sub-Tenon triamcinolone seems to be effective in chronic PCME following PPV.

Retinal injury mouse model and pathophysiological assessment of the effect of arsenical vesicants

The eye is ten times more vulnerable to chemical warfare agents than other organs. Consistently, exposure to vesicant arsenical lewisite (LEW) manifests significant corneal damage leading to chronic inflammation, corneal opacity, vascularization, and edema, culminating in corneal cell death. However, despite the progress has made in the research field investigating arsenical-induced pathogenesis of the anterior chamber of the eye, the retinal damage resulted from exposure to arsenicals has not been identified yet. Therefore, we investigated the effects of direct ocular exposure (DOE) to LEW and phenylarsine oxide (PAO) on the retina. DOE to arsenicals was conducted using the vapor cap method at the MRIGlobal facility or an eye patch soaked in solutions with different PAO concentrations at UAB. Animals were assessed at 1, 3, 14, and 28 days postexposure. Results of the study demonstrated that both arsenicals cause severe retinal damage, activating proinflammatory programs and launching apoptotic cell death. Moreover, the DOE to PAO resulted in diminishing ERG amplitudes in a dose-dependent manner, indicating severe retinal damage. The current study established a prototype mouse model of arsenical-induced ocular damage that can be widely used to identify the key cellular signaling pathways involved in retinal damage pathobiology and to validate medical countermeasures against the progression of ocular damage.

Symptoms: Purple Ear Drum and Hearing Loss

Symptoms: Purple Ear Drum and Hearing Loss

Clinical efficacy and safety of intravitreal fluocinolone acetonide implant for the treatment of chronic diabetic macular oedema: five-year real-world results.

To report 5-year real-world efficacy and safety data following the treatment of chronic diabetic macular oedema (DMO) with the intravitreal 0.19 mg fluocinolone acetonide implant(ILUVIEN). Retrospective cohort study of 31 eyes treated with ILUVIEN for chronic DMO at a tertiary centre in Birmingham (UK). Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded at baseline, and then at 1-,2-,3-, and 5-years. Safety was assessed based on intraocular pressure (IOP) -lowering medication, surgery, and other complications. BCVA significantly improved 1-year post-ILUVIEN (+4.2 letters, p < 0.05) and gradually reverted to baseline levels over the 5-year period of follow-up (+0.2 letters at year-5). A significant and sustained CRT reduction was observed throughout the 5-years. The proportion of eyes on IOP-lowering medication increased from 16% at baseline, to 70% at 5-years (p < 0.001) with eyes on a mean of 1.3 medications. Laser trabeculoplasty (n = 2), cyclodiode laser (n = 1), and trabeculoplasty and trabeculotomy (n = 1, in the same eye; 3.2%) were required for uncontrolled IOP. Other complications included endophthalmitis (n = 1) and vitreous haemorrhage (n = 1). 58% of eyes required additional intravitreal injections, with a mean 29.2 months to first injection. We observed a 69% reduction in treatment burden following treatment with ILUVIEN implant. Our real-world results confirm the efficacy of the ILUVIEN implant over 5 years, with two-thirds of eyes having improved or stable visual acuity 5 years after ILUVIEN, and an overall sustained improvement in anatomical outcome. Although the rate of IOP-lowering medications use was higher than previously reported, the rate of incisional IOP-lowering surgery and other complications remained low and in keeping with rates reported in larger studies.

Spontaneous resolution of treatment‐resistant foveal capillary macroaneurysms in retinal diseases

AbstractPurpose: Capillary macroaneurysms (CMAs), may be observed in many retinal diseases causing chronic macular edema. A targeted photocoagulation can be efficient to close extrafoveal CMAs. However, treatment of foveal CMAs can be challenging. We report 2 cases of foveal CMAs with chronic edema resistant to intravitreal injections (IVI), which spontaneously resolved after discontinuation of treatment.Methods: Patients with foveal aneurysms greater than 150 μm in diameter, related to retinal diseases and treatment‐resistant were evaluated with ophthalmologic examination and multimodal imaging.Results: Case 1: a 74‐year old female with retinal branch vein occlusion complicated with chronic macular edema was referred for treatment. Foveal macroaneurysm was detected on indocyanine green angiography (ICGA) and was resistant to ranibizumab followed by aflibercept monthly IVI. Six months after stopping treatment, macular edema spontaneously resolved with occlusion of the CMA.Case 2: a 82‐year old patient was treated for a chronic diabetic macular edema on his left eye. He received regular IVI of ranibizumab, aflibercept and dexamethasone implant without improvement. A retrofoveal CMA was noted on ICGA. After 4 months without IVI, the central macular thickness and the vision improved spontaneously.Conclusions: Chronic macular edema related to foveal CMAs is usually resistant to anti‐VEGF and steroid intravitreal injections. In some cases, spontaneous resolution of the macroaneurysm can occur when treatment is stopped.

Three wound types: common challenges with exudate, gaps and anatomical positioning

Complex wounds require combinations of technologies and regimes to match laboratory tests and address challenges of physiological processes, body contours, movement and ease of use during life-long self-management. Wound management for vascular and lymphatic disorders incorporate wound dressings, skin care and compression to address local wound needs and underlying pathologies, while allowing functionality for movement. In a similar manner, acute inflammatory conditions that become chronic require skin care and local conformable and absorbent wound management, but with simple, atraumatic retention methods without compression. Three types of conditions will be discussed in this article-venous leg ulcers with chronic oedema (VLU), hidradenitis suppurativa (HS) and pilonidal sinuses (PS). It focuses on overcoming challenges associated with excess exudate, compromised skin, dressing awkward areas and contours, while also demonstrating wound care similarities when administered by patients themselves.

Characterization of Descemet membrane of Fuchs endothelial corneal dystrophy by chromatic confocal microscopy

AbstractPurpose: Fuchs corneal endothelial dystrophy (FECD) causes chronic corneal edema and vision loss, and accounts for more than 50% of keratoplasty indications in occidental countries. The Descemet membrane (DM) gradually thickens because of extracellular matrix deposition and round excrescences named guttae accumulate. Chromatic confocal microscopy (CCM) is on optical device that analyses the nanotopography of surfaces.Aim: to study the feasibility of CCM technology to characterize guttae in FECD.Methods: Descemetorhexis of approximately 8 mm in diameter were obtained during endothelial grafts in 11 patients with FECD and control corneas were obtained from 3 donor corneas. The DM were fixed in 0.5% paraformaldehyde immediately after dissection. The CCM analysis was performed at room temperature on surfaces of 400 x 400 μm to characterize the DM with and without guttae. We measured positive and negative heights (peaks and valleys) relative to the mean altitude, as well as their distribution by asymmetry coefficient.Results: CCM resolution allowed to map nanotopography of the DM of FECD patients and controls. The surface of DM control was flat and homogeneous with maximum positive and negative heights of 1.07 ± 0.09 μm and 1.05 ± 0.07 μm, respectively. The height distribution was uniform with an asymmetry coefficient of 0.002 ± 0.23 μm, reflecting a Gaussian distribution (npeaks = nvalleys). The surface of FECD membranes was completely altered with a maximum peak of 6.05 ± 1.49 μm, up to 5.7 times higher than the control. The height distribution was disturbed with asymmetry value of 1.61 ± 0.79 μm (npeaks &gt; nvalleys) and a maximum valley height (3.09 ± 0.79 μm) that was half that of the peak one.Conclusions: CCM is a promising technology to quantitatively characterize the 3D organization of the DM surface. CCM can be used to classify the different types of surface lesions of the FECD corneas and to follow evolution of DM alteration at different stages of the disease.

Lymphedema of the limb: levels of bypass surgery

The paper provides information on the possible levels of performing shunting operations for limb lymphedema. The aim of the study was to study the anatomy of the lymphatic system of the skin and subcutaneous tissue in the clinic and in the experiment, comparing the data obtained with morphological changes occurring during the development of lymphedema. The substantiation of the levels of shunting operations is presented, taking into account the anatomy of the lymphatic system and pathophysiological changes in tissues during the development of chronic edema.

Calcium-channel blockers: Clinical outcome associations with reported pharmacogenetics variants in 32 000 patients.

Pharmacogenetic variants impact dihydropyridine calcium-channel blockers (dCCBs; e.g., amlodipine) treatment efficacy, yet evidence on clinical outcomes in routine primary care is limited. Reported associations in pharmacogenomics knowledge base PharmGKB have weak supporting evidence. We aimed to estimate associations between reported pharmacogenetic variants and incident adverse events in a community-based cohort prescribed dCCB. We analysed up to 32 360 UK Biobank participants prescribed dCCB in primary care (from UK general practices, 1990-2017). We investigated 23 genetic variants. Outcomes were incident diagnosis of coronary heart disease, heart failure (HF), chronic kidney disease, oedema and switching antihypertensive medication. Participants were aged 40-79 years at first dCCB prescription. Carriers of rs877087 T allele in RYR3 had increased risk of hazard ratio (HF 1.13: 95% confidence interval 1.02 to 1.25, P= .02). Although nonsignificant after multiple testing correction, the association is consistent with prior evidence. We estimated that if rs877087 T allele could experience the same treatment effect as noncarriers, the incidence of HF in patients prescribed dCCB would reduce by 9.2% (95% confidence interval 3.1 to 15.4). In patients with a history of heart disease prior to dCCB (n =2296), rs877087 homozygotes had increased risk of new coronary heart disease or HF compared to CC variant. rs10898815 in NUMA1 and rs776746 in CYP3A5 increased likelihood of switching to an alternative antihypertensive. The remaining variants were not strongly or consistently associated with studied outcomes. Patients with common genetic variants in NUMA1, CYP3A5 and RYR3 had increased adverse clinical outcomes. Work is needed to establish whether outcomes of dCCB prescribing could be improved by prior knowledge of pharmacogenetics variants supported by clinical evidence of association with adverse events.

Femtoassisted posterior lamellar keratoplasty in bullous keratopathy of stage IV–V (clinical application experience)

BACKGROUND: Bullous keratopathy is a chronic edema of the cornea, accompanied by a significant visual acuity loss and pain. The cause of bullous keratopathy is a pathological irreversible decrease in the number of endothelial cells, in which the endothelial layer cannot perform its main barrier and pumping functions.&#x0D; AIM: To evaluate the reproducibility and functional results of femto-assisted posterior lamellar keratoplasty using intraoperative OCT at the stage IVV of bullous keratopathy.&#x0D; MATERIALS AND METHODS: The study was conducted on 23 eyes of 23 patients diagnosed with stage IVV of bullous keratopathy. The mean age of patients was 69 12 years, there were 14 male patients and 9 female patients. Before surgery, light perception with correct light projection was recorded in 15 cases, in 5 cases the count of fingers at the face (0.005), in 3 cases visual acuity was 0.01. The central corneal thickness varied from 981 m to 1960 m and averaged 1008 96 m. Femto LDV Z8 femtosecond laser (Ziemer, Switzerland) was used to form an endothelial graft. All surgeries were performed using the Hi-R Neo 900 operating microscope with an integrated third-generation OCT module (Haag-Streit Surgical, Germany).&#x0D; RESULTS: No intraoperative complications were noted. The presence of objective control in the form of intraoperative OCT made it possible in all cases to clearly differentiate stromal and endothelial surfaces of the posterior layered graft located in the anterior chamber of the eye. The postoperative course was standard for posterior lamellar keratoplasty, accompanied by resorption of corneal edema with restoration of its transparency. The normalization of corneal thickness was noted by 1 month after surgery, and the restoration of corneal optical properties was noted by 36 months and was accompanied by gradual increase in visual acuity. Corrected visual acuity by 1 month was 0.05 0.03, by 3, 6, 12 months 0.1 0.05, 0.15 0.05 and 0.15 0.04, respectively. By 12 months after surgery, the central corneal thickness was 596 42 m, the thickness of the ultrathin graft tended to decrease somewhat to 67 8 m, the loss of endothelial cells was 59.3%. Endothelial graft survival was achieved in 82.6% of cases.&#x0D; CONCLUSIONS: The use of intraoperative OCT allows expanding the indications for posterior lamellar keratoplasty in bullous keratopathy, including the stage IVV of the disease.

The use of leg elevation in the treatment of chronic peripheral oedema.

Chronic peripheral oedema is a common long-term condition, with conflicting evidence on how it is best managed. It is crucial to establish the cause of the oedema to decide on the most appropriate intervention for its management. If the oedema is not managed, it can lead to unwanted complications for the service user. The District Nurse (DN) is pivotal in the management of patients with long-term conditions, both directly and indirectly. It is important that a multi-disciplinary approach is used, although nurses are now more autonomous due to advances in practice. The present study focuses on leg elevation as a form of intervention in the treatment of chronic peripheral oedema. As with any intervention, there are some risks with leg elevation that must be considered. This should be disseminated and monitored effectively.

Complications of First Tarsometatarsal Joint Arthrodesis

Category: Bunion Introduction/Purpose: Hallux valgus, a term introduced by Carl Hueter (1) to define static subluxation of the first metatarsophalangeal joint characterized by lateral deviation of the hallux and medial deviation of the first metatarsal, (1,2) is a disease for which different corrective surgical techniques can be used, depending on its severity. First tarsometatarsal joint (TMTJ) arthrodesis, also known as Lapidus, is one of the surgical procedures used in the treatment of severe hallux valgus, among other alterations (3-5). Despite the high satisfaction rate and high corrective power, this technique is not without complications. The main com- plications include delayed union, malunion, chronic edema, persistent pain, nonunion, joint stiffness, recurrent deformity, and varus deformity (6). However, there is little scientific evidence of these complications after first TMTJ arthrodesis. The purpose of this study was to report the complications of first TMTJ arthrodesis performed by orthopedic surgeons specializing in foot and ankle surgery. Methods: This study was approved by the institutional research ethics committee and registered at Plataforma Brasil. We evaluated 16 patients undergoing first TMTJ arthrodesis, who denied any comorbidities. The procedures were performed by 7 different orthopedic surgeons specializing in foot and ankle surgery with different levels of experience, ranging from 1 to 29 years of experience in the field. All patients underwent arthrodesis with plates and screws. The plate was placed on the plantar aspect of the first tarsometatarsal in 4 patients and on the anteromedial aspect in all other patients. The dorsomedial incision was used, centered on the first TMTJ, for the 12 cases in which the plate was positioned in the dorsomedial region, and the medial incision was used for the 4 cases in which the plate was positioned on the plantar aspect. Also, articular cartilage was resected using a chisel and microperforations. All 16 patients were followed up in an outpatient clinic at 1, 2, 4, 6, 12, and 24 weeks postoperatively. The follow-up visits included the evaluation of anteroposterior, lateral, and oblique radiographs of the foot, clinical alignment of the hallux, and patients' signs and symptoms. For all patients, postoperative care included immobilization in a non-weight-bearing cast for 4 weeks, initiation of physical therapy with range of motion gain at 4 weeks, and partial weight- bearing at 6 weeks Results: We evaluated 16 patients operated on over an 18-month period (from February 2017 to August 2018). We measured preoperative and postoperative hallux valgus and intermetatarsal angles (Table 1). Eight patients had either major or minor complications (Table 2). Three patients had recurrent deformity (1 with associated nonunion), 2 had delayed union, 2 had hardware loosening (Figure 1) - 1 with associated nonunion (Figure 2), and 1 had wound dehiscence. Conclusion: Based on our study, we can conclude that first TMTJ arthrodesis requires greater care in choosing the surgical technique for the treatment of hallux valgus. In addition, some points should be considered to avoid complications as much as possible, such as the use of implants to increase stability, instruments for better articular cartilage resection, and improvement in the correction of the pronation deformity of the hallux. The limitations of our study prevent us from drawing a robust conclusion and defining consistent parameters related to the main factors that may affect the various complications described in the study. Therefore, we believe that data are still scarce to provide a concrete basis, and further studies are needed to make substantiated conclusions.