Cohort Comparison of Radiographic Correction and Complications Between Minimal Invasive and Open Lapidus Procedures...

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Minimally Invasive Procedures

Background:

• The Lapidus procedure is a standard surgical correction for hallux valgus first ray deformity.
• Minimally invasive surgery (MIS) presents a novel approach to first tarsometatarsal (TMT) fusion for hallux valgus.
• Comparative outcome data between MIS and open TMT fusion techniques are limited.

Purpose of the Study:

• To compare the early radiographic outcomes and complication rates of MIS versus open Lapidus procedures.
• To evaluate the effectiveness of MIS TMT fusion against traditional open techniques in hallux valgus correction.

Main Methods:

• A retrospective comparison of 47 patients who underwent MIS TMT fusion and 44 patients who underwent open TMT fusion.
• Preoperative and postoperative radiographic measurements included intermetatarsal angle (IMA), hallux valgus angle (HVA), foot width (FW), and others.
• Complications and need for revision surgery were recorded for both groups.

Main Results:

• Both MIS and open techniques significantly improved postoperative IMA, HVA, distal metatarsal articular angle (DMAA), foot width (FW), and sesamoid station (SS).
• The open group demonstrated significantly lower postoperative IMA and greater correction for both IMA and HVA compared to the MIS group.
• Wound complications and nonunion rates trended higher in the open group (4 vs 0), though not statistically significant (P = .051).

Conclusions:

• Both open and MIS Lapidus procedures achieve good to excellent correction for hallux valgus.
• The open technique provides superior correction of IMA and HVA compared to MIS.
• MIS may offer advantages in reduced wound complications and nonunion rates, warranting further investigation.