Lapidus arthrodesis for management of hallux valgus--a retrospective review of 106 cases.
One hundred six patients who underwent a Lapidus arthrodesis for a symptomatic hallux valgus deformity, mainly with first ray hypermobility, were retrospectively reviewed. Radiograph and chart reviews were performed in addition to a patient survey completed at a mean 17 months postoperatively. Of the 78 patients who completed the survey, 70.5% were satisfied with the procedure; 80.2% would choose the same method again. Seven percent of patients were dissatisfied. Review of preoperative and 3-month postoperative radiographs showed a mean intermetatarsal angle reduction of 12.4 degrees . The average postoperative sesamoid position was 2.5, a 4.0 reduction from the preoperative mean value of 6.5. The complication rate was 5.7%, including 2 nonunions (1.8%) requiring a repeat surgery, 1 deep-vein thrombosis (0.9%), and 3 patients with complex regional-pain syndrome (2.7%). In 16% of patients, resolution of swelling and subjective complaints took longer than 3 months; 4.7% of patients developed sesamoiditis or metatarsalgia that resolved with conservative measures. Radiographic undercorrection was evident in 4.7% of patients. The results showed that the Lapidus procedure provided reliable correction in cases of severe hallux valgus with intermetatarsal angles >15 degrees and in those patients with first ray hypermobility.
Department of Surgery, St. Josefs-Hospital, Bochum, Germany. orink-bruene@bochum.helios-kliniken.de <orink-bruene@bochum.helios-kliniken.de>
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Rink-Brüne
D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D005260:Female; D033023:Foot Joints / Q000601:surgery; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies