Critical evaluation of the modified lapidus procedure

McInnes, Brian; Bouché, Richard T.

doi:10.1016/s1067-2516(01)80048-x

Cited by 95 publications

(37 citation statements)

References 14 publications

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“…This joint is deep, varying from 2.6 to 3.2 cm. 7 The articular cartilage was then removed with a small curved osteotome and careful attention was paid to the plantar aspect of the joint where there often is a concave lip on the first metatarsal base. Failure to remove this plantar articular cartilage can result in failure of a solid fusion and interfere with ultimate positioning and correction of deformity.…”

Section: Operative Proceduresmentioning

confidence: 99%

“…Fusion of the first tarsometatarsal joint (TMTJ) has been used for the correction of hallux valgus, metatarsus primus varus 1,2,4,7,9,10,11,12,13 and endstage arthritis. 5,8 Symptomatic hallux valgus deformity and adult flatfoot conditions can present in many forms, and there is no single operative procedure to correct them.…”

Section: Introductionmentioning

confidence: 99%

“…One criticism of the modified Lapidus procedure is the unacceptable nonunion rate of the TMTJ; up to 12% has been consistently reported. 2,7,9,10,11,12 Because of this high nonunion rate the modified Lapidus procedure is not commonly done.…”

Section: Introductionmentioning

confidence: 99%

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Fusion Rate of First Tarsometatarsal Arthrodesis in the Modified Lapidus Procedure and Flatfoot Reconstruction

2005

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Section: Operative Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fusion Rate of First Tarsometatarsal Arthrodesis in the Modified Lapidus Procedure and Flatfoot Reconstruction

2005

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“…The modified Lapidus procedure, consisting of fusion of the first tarsometatarsal (TMT) joint with concurrent distal soft tissue realignment, has commonly been utilized for patients with moderate to severe hallux valgus deformity in the setting of a hypermobile first ray [10,13,16,18]. Instability of the first ray is believed to contribute to deformity and pain.…”

Section: Introductionmentioning

confidence: 99%

Modified Lapidus Procedure with Joint Compression, Meticulous Surface Preparation, and Shear-Strain-Relieved Bone Graft Yields Low Nonunion Rate

Mani

Lloyd

MacMahon

et al. 2015

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: The modified Lapidus procedure is widely used to correct hallux valgus but has been reported with high nonunion rates. In this study, we retrospectively reviewed the nonunion rate of the modified Lapidus procedure performed with rigid cross screw fixation, meticulous joint preparation, and shear-strain-relieved calcaneal bone graft. Questions/Purposes: Does the performance of the Lapidus procedure with rigid cross screw fixation, complete joint preparation, and shear-strain-relieved calcaneal bone graft achieve higher union rates than currently reported? If nonunion does occur, what is the clinical course? Methods: We reviewed both radiographic and clinical results of the modified Lapidus procedure with the above technique in 171 patients (182 feet). Evaluation included age, gender, tobacco use, diabetic status, and radiographic analysis at least 3 months postoperatively. Results: The modified Lapidus procedure described above resulted in a union rate of 97.3% (177 of 182 feet). Three of the five feet with radiographic nonunions were clinically symptomatic. Conclusions: The union rate of the modified Lapidus procedure is higher than previously reported when performed with rigid cross screw fixation, meticulous joint preparation, and shear-strain-relieved bone graft. Nonunion of the first tarsometatarsal joint should be considered an infrequent occurrence.

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“…Shortening of 2.7 mm for TMT1 fusion is slightly greater [8]. Primary use of TMT1 fusion shows shortening rates of 4 mm [4], 4.7 mm [5], 4.5 mm [22], and 5 mm [27].…”

Section: Discussionmentioning

confidence: 86%

The Scarf Osteotomy: A Salvage Procedure for Recurrent Hallux Valgus in Selected Cases

Böck

Lanz

Kröner

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background The Scarf osteotomy was described as a technique to correct a metatarsus primus varus in primary hallux valgus surgery, but it is unclear whether the technique could correct recurrent hallux valgus when an initial procedure failed to provide any or an adequate lateral displacement of the metatarsal head. Questions/purposes We asked whether the Scarf osteotomy could reduce pain, improve the AOFAS score, reduce the deformity, and prevent further recurrence when used as a revision procedure. Patients and Methods Of 41 patients (45 feet) we treated for failed initial operations, we retrospectively reviewed 35 (39 feet) who underwent a Scarf osteotomy. We administered a VAS for pain and the AOFAS score preoperatively and postoperatively. Preoperative and postoperative radiographs were taken to assess the hallux valgus angle [HVA] and intermetatarsal angle [IMA]. The minimum followup was 24 months (mean, 42 months; range, 24-89 months). Results The mean VAS for pain improved from 5.9 to 0.4 points. The mean AOFAS score improved from 56 to 90 points. The radiographic evaluation showed improvement of the mean HVA from 30°to 8°and improvement of the IMA from 13°to 4°. Complications included one asymptomatic recurrence with a 20°-HVA, one overcorrection with a

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Critical evaluation of the modified lapidus procedure

Cited by 95 publications

References 14 publications

Fusion Rate of First Tarsometatarsal Arthrodesis in the Modified Lapidus Procedure and Flatfoot Reconstruction

Fusion Rate of First Tarsometatarsal Arthrodesis in the Modified Lapidus Procedure and Flatfoot Reconstruction

Modified Lapidus Procedure with Joint Compression, Meticulous Surface Preparation, and Shear-Strain-Relieved Bone Graft Yields Low Nonunion Rate

The Scarf Osteotomy: A Salvage Procedure for Recurrent Hallux Valgus in Selected Cases

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