Lapidus arthrodesis with a single lag screw and a locking H-plate

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery

Background:

• Hallux abducto valgus deformity often requires surgical intervention, such as the Lapidus arthrodesis.
• Traditional Lapidus arthrodesis fixation methods may involve longer periods before weight-bearing is permitted.
• Assessing novel fixation techniques is crucial for improving patient outcomes and recovery times.

Purpose of the Study:

• To evaluate the safety and efficacy of using an interfragmental lag screw and a Darco locking H-plate for modified Lapidus arthrodesis.
• To determine if this fixation construct allows for earlier weight-bearing compared to previous methods.
• To assess radiographic changes associated with earlier weight-bearing after this surgical technique.

Main Methods:

• Retrospective review of 21 metatarsocuneiform arthrodesis procedures in 18 patients.
• Evaluation of chart data and postoperative radiographs for osseous union and fixation integrity.
• Analysis of time to full weight-bearing and return to comfortable shoe wear.

Main Results:

• A high osseous union rate of 90.5% (19/21 feet) was observed, with two asymptomatic nonunions.
• No fixation failures occurred, and surgical correction was maintained at follow-up.
• The mean time to full weight-bearing was 4.7 weeks, with patients returning to comfortable shoes in a mean of 8 weeks.

Conclusions:

• Metatarsocuneiform arthrodesis using a single interfragmentary lag screw and a Darco locking H-plate offers sufficient stability.
• This construct facilitates earlier weight-bearing than previously reported fixation methods for hallux abducto valgus.
• The technique shows promise for improving recovery timelines in patients undergoing modified Lapidus arthrodesis.