120 postmenopausal women with osteoporosis and hallux valgus who were scheduled for combined Lapidus arthrodesis and Akin osteotomy were randomized to postoperative intervention an infusion of either 5mg zoledronic acid or placebo saline. Patients were followed-up for nonunion rates at the fusion and osteotomy sites, and clinical outcome on the Orthopedic Foot and Ankle Society (AOFAS) score. Nonunion rates of the first tarsometatarsal joint and first metatarosphalangeal joint did not significantly differ between groups after 8 or 12 weeks, nor did AOFAS scores after 24 weeks.