Modified lapidus arthrodesis: rate of nonunion in 227 cases

Patel, Sandeep; Ford, Lawrence A.; Etcheverry, John; Rush, Shannon M.; Hamilton, Graham A.

doi:10.1053/j.jfas.2003.11.009

Cited by 119 publications

(53 citation statements)

References 14 publications

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“…A larger amount of bone was removed from the lateral surface to ensure adequate reduction of the intermetarsal angle. Care was taken to [13] 227 (211) 46.9 5.3 Thompson (2005) [18] 201 (185) 53 4 Blitz (2010) [2] 80 (76) 50.6 0 Menke (2011) [11] 21 (18) 48 9.5 ensure that all cartilage was removed during these saw cuts. Intraoperative radiographic assessment confirmed the reduction of the intermetatarsal angle.…”

Section: Methodsmentioning

confidence: 99%

“…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%

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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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Section: Methodsmentioning

confidence: 99%

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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show abstract

“…The screws inserted in the sagittal plane can resist cantilever loads applied to the first metatarsal during midstance. 9,23 The crossed screw construct also allow early weightbearing without an increased complication rate. 6 In summary, nonunion of first metatarsocuneiform joint fusion with screw loosening and associated bone cyst formation can be revised by bone endoscopy through the screw tract.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Nonunion of the first metatarsocuneiform joint fusion is the most frequent complication, with a reported rate range from 3.3% to 12%. 9,10 In case of symptomatic nonunion, revision arthrodesis is indicated. Revision by arthroscopic Lapidus arthrodesis has been reported recently for nonunion cases with good positioning of the first metatarsal and no loosening of the screw.…”

mentioning

confidence: 99%

Revision Lapidus Arthrodesis by Bone Endoscopy

Lui¹

2016

Arthroscopy Techniques

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Revision arthrodesis is indicated in symptomatic nonunion of the first tarsometatarsal joint. Revision by first tarsometatarsal arthroscopy cannot deal with the dilated screw tract and associated bone cysts. Revision by bone endoscopy is indicated in symptomatic nonunion of the first tarsometatarsal joint, which is previously fixed by transarticular screw along with loosening of the screw and bone cyst formation. The screw tract makes up the portal tract, with the proximal and distal ends of the tract corresponding to the proximal and distal portals, respectively. In this technical note, we describe zonal debridement and bone grafting of the bone cysts, nonunion site, and the screw tract via the bone endoscopy. This can resolve all the co-pathologies of nonunion of the first tarsometatarsal fusion.

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“…• Nonunion: the cause is either an inadequate removal of articular cartilage, an insufficient adaptation of the resection surfaces, or a deficient postoperative care. The risk of nonunion varies between 5% and 10% [3,9,10]. Revision with interposition of a corticocancellous graft is usually indicated followed by application of a below-knee cast.…”

Section: Errors Hazards Complicationsmentioning

confidence: 99%

Die Korrekturarthrodese des ersten Tarsometatarsalgelenks zur Behandlung des fortgeschrittenen Spreizfußes mit Halluxvalgus-Fehlstellung

Fuhrmann

2005

Orthop Traumatol

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one reflex sympathetic dystrophy, four nonunions of the first tarsometatarsal joint (6.2%). Radiologic evidence of consolidation at a mean of 9 weeks. Improvement of the first intermetatarsal angle from 20.4 degrees to 11.2 degrees. Pressure measurement showed a significantly improved load-carrying capacity of the first ray. The score of the American Orthopaedic Foot and Ankle Society improved significantly (p < 0.01) from 51 to 92 points.

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Modified lapidus arthrodesis: rate of nonunion in 227 cases

Cited by 119 publications

References 14 publications

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

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

Revision Lapidus Arthrodesis by Bone Endoscopy

Die Korrekturarthrodese des ersten Tarsometatarsalgelenks zur Behandlung des fortgeschrittenen Spreizfußes mit Halluxvalgus-Fehlstellung

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