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Updated: Jun 24, 2026
An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
Intercuneiform stabilization during a modified Lapidus procedure for hallux valgus results in decreased
Amanda Irene Zeng1, Jaeyoung Kim1, Joseph Nguyen1
1Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, United States.
Background:
Over 10% of patients remain dissatisfied following hallux valgus (HV) surgery, often due to recurrence of the deformity. This study investigates whether adding an intercuneiform screw (ICS) from the first metatarsal (M1) to the middle cuneiform (C2) during first tarsometatarsal arthrodesis reduces recurrence and C1-C2 gapping.
Methods:
A retrospective cohort of 171 patients undergoing modified Lapidus were categorized by TMT1 fixation: dual crossed-screws (NS; n = 87) or intercuneiform screw with dorsal-plate (ICS; n = 84). Weightbearing CT images were used to assess the hallux valgus angle (HVA), intermetatarsal angle (IMA), C1-C2 distance, sesamoid position, and first metatarsal pronation.
Results:
Recurrence occurred in 6.9% of NS patients, but none in the ICS group (p = 0.029). ICS showed improved HVA (p = 0.036), first metatarsal pronation (p = 0.009), sesamoid station (p = 0.009), and reduced C1-C2 gapping (p < 0.001), with no difference in IMA (p = 0.728).
Conclusion:
Intercuneiform stabilization with an M1-C2 screw reduced HV recurrence and C1-C2 joint gapping, while improving first metatarsal pronation and sesamoid reduction.
Level Of Evidence:
Level IV, retrospective case series study.