Modified Lapidus procedure with a nitinol staple and two screw construct technique
Chad A Smith1, Lauren M Christie1, Steven R Cooperman1
1Fellow; Orthopedic Foot and Ankle Center Advanced Foot and Ankle Reconstruction Fellowship, 350 W. Wilson Bridge Rd, Ste. 200, Worthington, OH 43085, USA.
Summary
This study found that a nitinol staple and two-screw construct effectively treats hallux valgus. This fixation method for first tarsometatarsal joint arthrodesis demonstrated a low non-union rate and reliable outcomes.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Podiatric medicine
Background:
- Hallux valgus correction often involves first tarsometatarsal joint arthrodesis.
- Various fixation methods exist, each with advantages and disadvantages.
- Nitinol (shape memory alloy) staples are an under-explored fixation option.
Purpose of the Study:
- To evaluate the efficacy of a modified Lapidus technique using a nitinol staple and a two-screw construct.
- To assess non-union rates, time to weightbearing, and hardware complications.
- To determine the reliability of this fixation method for hallux valgus correction.
Main Methods:
- Retrospective review of 42 patients undergoing first tarsometatarsal joint arthrodesis.
- Utilized a nitinol staple combined with a two-screw construct for fixation.
- Evaluated outcomes including bony union, weightbearing progression, and revision rates.
Main Results:
- Achieved bony union in 97.92% of cases (2.08% non-union rate).
- Average time to weightbearing in a boot was 27.35 days; in a shoe, 55.58 days.
- 3.125% of patients required staple removal; no revisions were needed for loss of correction or non-union.
Conclusions:
- The nitinol staple and two-screw construct is a reliable fixation method for first tarsometatarsal joint arthrodesis in hallux valgus.
- This technique demonstrates comparable results to existing fixation options.
- Further research may support wider adoption of nitinol staples in foot and ankle surgery.
