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Outcomes of Lapidus Procedure Without Focused Frontal Plane Rotation of the First Metatarsal
Alan Banks1, Chandler Ligas1, Donald Scot Malay2
1Emory Decatur Hospital, Decatur, GA 30033, USA.
Summary
The Lapidus arthrodesis effectively corrects hallux valgus deformities without needing specific frontal plane rotation of the first metatarsal. This surgical approach, combined with lateral release, offers similar outcomes to methods involving derotation.
Area of Science:
- Orthopedic Surgery
- Radiographic Analysis
- Foot and Ankle Reconstruction
Background:
- Presents a retrospective radiographic analysis of Lapidus arthrodesis for hallux valgus correction.
- Investigates the efficacy of the procedure without focused frontal plane rotation of the first metatarsal.
Purpose of the Study:
- To evaluate the radiographic outcomes of Lapidus arthrodesis in correcting hallux valgus.
- To determine if significant frontal plane rotation of the first metatarsal is necessary for successful correction.
Main Methods:
- Retrospective analysis of 33 feet in 30 patients undergoing Lapidus arthrodesis (2015-2020).
- Median patient age 55.4 years, 76.7% female.
- Median follow-up duration of 15.9 months.
Main Results:
- Significant reduction in first intermetatarsal angle (16° to 5°, p < 0.001).
- Significant reduction in hallux abductus angle (37° to 8.5°, p < 0.001).
- Significant improvement in tibial sesamoid position (6 to 3, p = 0.001).
Conclusions:
- The radiographic first metatarsal lateral round sign is ambiguous.
- Lapidus arthrodesis with lateral release can correct significant hallux valgus without focused first metatarsal derotation.
- Outcomes appear comparable to studies employing focused frontal plane rotation.