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Lapidus bunionectomy

Thomas A Paulick, Brian J Conley, Robert M Brarens, Renee L Ash
To date, few studies discussing the use of rail external fixation for the Lapidus procedure have presented acceptable complication rates. At least 1 study has suggested the technique is not recommended for routine use with this procedure. We present 2 methods of external fixation application and 2 protocols of early postoperative weightbearing in 25 patients, with a marked decrease in complication rates from previously published studies. A retrospective study of 25 patients (within 2 patient groups) was performed, with a mean follow-up of 20 (range 12 to 38) months...
May 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Christy M King, Graham A Hamilton, Lawrence A Ford
Hallux valgus with or without first ray insufficiency has been strongly implicated as a contributing factor in lesser metatarsal overload. The principle goals of a bunionectomy are to relieve the pain, correct the deformity, and restore first metatarsophalangeal joint congruity. Until now, little evidence has been available to assess the effects of bunionectomy procedures on forefoot pressure. The primary aim of the present prospective study was to evaluate the preoperative and postoperative plantar pressures after 2 specific bunionectomies: the chevron bunionectomy and Lapidus arthrodesis...
July 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
N Gutteck, D Wohlrab, A Zeh, F Radetzki, K-S Delank, S Lebek
The treatment of hallux valgus in patients with pathology of the first tarsometatarsal (TMT I) joint by fusion is an established procedure. Multiple osteosynthesis methods for the fixation of the TMT I joint are available. In comparison to the distal procedures the Lapidus bunionectomy is associated with a pseudarthrosis rate of up to 12% [9-11]. We present results after TMT-I arthrodesis using an interfragmentary screw and a plantar plate compared with an interfragmentary screw and a dorsomedial locking plate...
December 2013: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Neal M Blitz
The Lapidus procedure should no longer be considered a strict nonweightbearing bunionectomy. In the past few years, several studies have emerged demonstrating that early weightbearing after a Lapidus fusion is indeed possible with satisfactory fusion rates. This is mainly because of improved fixation techniques available today, which have allowed for better stabilization of the fusion site. Surgeons should still properly indicate patients for early weightbearing protocols.
July 2012: Clinics in Podiatric Medicine and Surgery
Pierce E Scranton, J Chris Coetzee, Dominic Carreira
BACKGROUND: The Lapidus bunionectomy is a popular procedure for severe bunion deformity where metatarsus primus varus is equal to or exceeds 15 degrees. We evaluated a new locking compression plate which may improve outcomes with the Lapidus procedure. METHODS: Ten matched pairs of cadaver feet were used to compare the standard crossed 4.0-mm compression screw method of fixation to the LPS Lapidus plate. After performing the matched operations the cadaver constructs were stressed to failure using the INSTRON and Wavemaker software...
April 2009: Foot & Ankle International
Amol Saxena, Aidan Nguyen, Elise Nelsen
UNLABELLED: We compared outcomes of the Lapidus bunionectomy fixated with crossed lag screws versus a locking plate with a plantar lag screw. Forty patients who underwent Lapidus bunionectomy between August 2001 and May 2006 were evaluated in a combined retrospective and prospective fashion. Crossed lag screws were used in 19 of the patients, and a locking plate with a plantar lag screw was used in 21 of the patients. Other than fixation, the only interventional difference pertained to postoperative weight bearing, where those receiving the plate initiated full weight bearing on the operated foot at 4 weeks postoperative, as compared to 6 weeks for those receiving crossed screws...
March 2009: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Nicholas J Bevilacqua, Lee C Rogers, James S Wrobel, David Z Shechter
The authors reviewed the records of 8 patients who underwent a distraction scarf osteotomy of the first metatarsal, and report the radiographic outcomes achieved with this procedure. The osteotomy was used to reestablish or maintain the length of the first metatarsal, without the use of a structural bone graft. The osteotomy was used as part of a revisional procedure for a failed bunionectomy in 4 patients. In the remaining patients, the procedure was used to preserve the length of the first metatarsal in conjunction with a Lapidus arthrodesis...
March 2008: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
James C Wang, Brendan M Riley
Presented here is a preliminary report of 102 patients who underwent first metatarsocuneiform joint arthrodeses performed with external fixation for the correction of hallux valgus. The advantages of using external fixation are the ability to initiate early weightbearing, predictable fusion, and removal of all of the hardware postoperatively. In the 102 patients reported here, the average time to initiation of unassisted full weightbearing was 13.1 days. The average time to fusion was 5.3 weeks, with removal of the external fixator at an average of 5...
July 2005: Journal of the American Podiatric Medical Association
Babak Baravarian, Gary B Briskin, Patrick Burns
Fusion of the first metatarsocunieform (MC) joint allows for correction of the first metatarsal in three planes, including adduction, plantarflexion, and rotation. It also allows for decreased jamming of the great toe joint and increased medial column stability. As knowledge about other medial column procedures grows, fusion of the first MC joint will continue to grow in popularity. It is an excellent procedure for hallux limitus and also for metatarsus primus elevatus cases.
January 2004: Clinics in Podiatric Medicine and Surgery
T A Neylon, B A Johnson, R A Laroche
Surgical management of first ray insufficiency in HAV or hallux limitus is crucial to long-term success. Although technically demanding, the Lapidus fusion serves to address the deformity at its apex and restores normal weight bearing to the foot. This arthrodesis offers predictable, durable results in addressing various first ray deformities and occupies an important place in the foot and ankle surgeon's armamentarium. The authors' technique is described herein for the interest of and evaluation by surgeons performing this procedure...
April 2001: Clinics in Podiatric Medicine and Surgery
L S Weil
The Scarf osteotomy has proven to be a versatile and powerful procedure to correct various degrees of hallux valgus deformity. Through modifications of bone-cut lengths and in combination with a phalangeal osteotomy, most hallux valgus deformities can be addressed. In cases of extreme hypermobility of the first ray or arthrosis of the first metatarsocuneiform joint, the Lapidus operation may be more appropriate. Hallux valgus rigidus or hallux valgus with severe rheumatoid joint disease usually requires alternative procedures...
September 2000: Foot and Ankle Clinics
B X Chen
This is a review of the treatment of hallux valgus based on the paper material submitted to the First and Second Sino-American Conferences on Foot Disorders held in Beijing in 1987 and 1990. The data consisted of 676 cases (979 feet) from 10 major hospitals in China. There were 122 men and 554 women, giving a male to female ratio of 1:45. Sixty-nine (10%) cases had a family history of hallux valgus and 120 cases (18%) were associated with hammer toe deformity. The age ranged from 16-85 years with an average of 42...
April 1992: Chinese Medical Journal
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