Modified Lapidus Arthrodesis With Crossed Screw Fixation: Early Weightbearing in 136 Patients

King, Christy M.; Richey, Johanna Marie; Patel, Sandeep; Collman, David R.

doi:10.1053/j.jfas.2014.09.034

Cited by 40 publications

(32 citation statements)

References 34 publications

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“…9,23 The crossed screw construct also allow early weightbearing without an increased complication rate. 6 In summary, nonunion of first metatarsocuneiform joint fusion with screw loosening and associated bone cyst formation can be revised by bone endoscopy through the screw tract.…”

Section: Discussionmentioning

confidence: 99%

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Revision Lapidus Arthrodesis by Bone Endoscopy

Lui¹

2016

Arthroscopy Techniques

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Revision arthrodesis is indicated in symptomatic nonunion of the first tarsometatarsal joint. Revision by first tarsometatarsal arthroscopy cannot deal with the dilated screw tract and associated bone cysts. Revision by bone endoscopy is indicated in symptomatic nonunion of the first tarsometatarsal joint, which is previously fixed by transarticular screw along with loosening of the screw and bone cyst formation. The screw tract makes up the portal tract, with the proximal and distal ends of the tract corresponding to the proximal and distal portals, respectively. In this technical note, we describe zonal debridement and bone grafting of the bone cysts, nonunion site, and the screw tract via the bone endoscopy. This can resolve all the co-pathologies of nonunion of the first tarsometatarsal fusion.

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Section: Discussionmentioning

confidence: 99%

“…It is also indicated as part of the surgical correction of severe hallux valgus or other foot deformity involving the medial foot column. [2][3][4][5][6] It is classically performed as an open procedure. Recently, the technique of arthroscopic Lapidus arthrodesis has been reported with the advantage of preservation of the soft-tissue envelope.…”

mentioning

confidence: 99%

Revision Lapidus Arthrodesis by Bone Endoscopy

Lui¹

2016

Arthroscopy Techniques

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“…Diferentes procedimentos foram descritos para tratar os vários graus de deformidades do hálux valgo (7,8) , e a artrodese da primeira articulação tarso-metatarso, descrita por Lapidus em 1934 (9) , encontra-se bem estabelecida e com grande aceitação ao longo das últimas décadas (10) . Apesar de originalmente ter sido indicada para a correção de casos graves de metatarso primo varo do adolescente, suas indicações evoluíram ao longo dos anos e, atualmente, sua indicação é amplamente aceita no tratamento dos hálux valgos moderados e graves do adulto com grande deslocamento do sesamoide tibial, e também nos casos de recidiva que utilizaram outras técnicas (10)(11)(12) .…”

Section: Introductionunclassified

“…Para aumentar a estabilidade da técnica e permitir descarga de peso mais precoce, foram desenvolvidas algumas alternativas, dentre elas a fixação da artrodese com placa e parafusos, mais estável do ponto de vista mecânico, o que poderia causar menos dor, edema e/ou outros sintomas pós-operatórios (10) . Entretanto, é um procedimento que tem um custo mais elevado quando comparado a outras osteotomias proximais (7,13) , e não está isento de outras complicações, como síntese saliente e dolorosa e necessidade de retirada do material (11,13) .…”

Section: Introductionunclassified

“…Outra modificação consiste na utilização de um ponto adicional de fixação óssea, que pode ser um fio de Kirschner posicionado transversalmente através das diáfises dos primeiro e segundo metatarsos (10,11) . Ela complementa a tradicional fixação interfragmentária com parafusos de compressão, e o fio de Kirschner tem o objetivo de minimizar o efeito de braço de alavanca sobre o primeiro metatarso, neutralizando o torque no foco de fusão e permitindo ao paciente realizar descarga de peso mais precoce no pós-operatório (10) .…”

Section: Introductionunclassified

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Sesamoid complex angle correction after arthrodesis of the first cuneometatarsal joint in the treatment of hallux valgus

et al. 2018

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Objective: To evaluate the degree of sesamoid complex correction in patients with moderate and severe hallux valgus undergoing cuneometatarsal arthrodesis by comparing general pre- and postoperative values and also post-reduction outcomes between moderate and severe cases. Methods: The radiographs of 24 patients (83.3% females and 16.7% males) who underwent arthrodesis of the first cuneometatarsal joint wereretrospectively analysed. The patients’ mean age was 52.58 years. The metatarsophalangeal, intermetatarsal and sesamoid dislocation angles were measured on the preoperative and immediate postoperative radiographs, with the former measured in the standing position and the latter measured intraoperatively, all in the anteroposterior incidence. The first metatarsal lateralization necessary to centralize the sesamoids wasmeasured in degrees. We refer to this angle as the “angle to be corrected”. Results: We achieved sesamoid dislocation correction, reducing the indicated angles in relation to their preoperative values. Both moderate and severe cases showed statistically significant differences in angular correction after surgery, with p=0.018 and p<0.001, respectively. Comparing the moderate and severe cases, a statistically significant difference was observed preoperatively, with p=0.007; however, the results were not statistically significant postoperatively (p=0.227). Conclusion: We achieved effective correction of the ABC in terms of both the total patient sample and the isolated analysis of the moderate and severe groups. Preoperatively, the moderate cases had smaller angles than the severe cases, but both groups exhibited reductions in these angles in the postoperative period and had similar outcomes. Level of Evidence III; Retrospective Study.

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Lapidus Bunionectomy

Hatch¹

2020

Evidence-Based Podiatry

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Modified Lapidus Arthrodesis With Crossed Screw Fixation: Early Weightbearing in 136 Patients

Cited by 40 publications

References 34 publications

Revision Lapidus Arthrodesis by Bone Endoscopy

Revision Lapidus Arthrodesis by Bone Endoscopy

Sesamoid complex angle correction after arthrodesis of the first cuneometatarsal joint in the treatment of hallux valgus

Lapidus Bunionectomy

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