Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지
DOI QR코드

DOI QR Code

The Results of Modified Lapidus Procedure on Moderate-to-Severe Hallux Valgus with First Tarso-Metatarsal Joint Hypermobility

제 1족근-중족관절 과운동성과 중등도 이상의 변형을 동반한 무지외반증에 대한 변형 Lapidus 술식의 결과

  • Lee, Won Young (Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sung, Ki-Sun (Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Chaehoon (Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 이원영 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 성기선 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 정재훈 (성균관대학교 의과대학 삼성서울병원 정형외과학교실)
  • Received : 2017.05.15
  • Accepted : 2017.06.21
  • Published : 2017.09.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The objective of this study was to confirm the results of the modified Lapidus procedure on moderate to severe hallux valgus patients with first tarso-metatarsal joint hypermobility. Materials and Methods: A retrospective study was conducted on 42 cases of 35 patients who underwent the modified Lapidus procedure between March 2006 and December 2014. A comparative analysis was performed on the preoperative and postoperative subjective satisfaction of patients and radiologic index. Moreover, the correlation between the follow-up time and patient's operative satisfaction, as well as between the proficiency of the operator and patient's operative satisfaction was analyzed. Complications were also evaluated. Results: Out of the total of 35 patients, 3 were male and 32 were female. The mean age was 61.3 years (range, 34~79 years), and the mean follow-up time was 22.1 months (range, 6~90 months). The overall satisfaction level was 67.6% and the mean hallux valgus angle improved from preoperative $40.5^{\circ}$ to postoperative $12.2^{\circ}$ (p<0.001). The mean 1, 2 intermetatarsal angle improved from preoperative mean of $16.9^{\circ}$ to postoperative mean of $7.6^{\circ}$ (p<0.001), and the sesamoid position improved significantly, from preoperative 2.7 to postoperative 0.9 (p<0.001). Furthermore, there was no correlation between the follow-up time and the American Orthopaedic Foot and Ankle Society (AOFAS) hallux scale; also no correlation between the year the operation took place and the AOFAS hallux scale. In terms of complications, we observed screw irritation in 6 cases, hallux varus in 2 cases, and recurrence of hallux valgus and nonunion in one case. Conclusion: Contrary to our concerns, the level of complications was not high; however, the satisfaction level of patients was also not very high. Therefore, careful selecting of patients and sufficient consultation time is needed before surgery. In addition, since the causes of postoperative dissatisfaction still remain unclear, further studies are necessary.

Keywords

References

  1. Johnson AE, Georgopoulos G, Erickson MA, Eilert R. Treatment of adolescent hallux valgus with the first metatarsal double osteotomy: the denver experience. J Pediatr Orthop. 2004;24:358-62. https://doi.org/10.1097/01241398-200407000-00003
  2. Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010;3:21. https://doi.org/10.1186/1757-1146-3-21
  3. Owoeye BA, Akinbo SR, Aiyegbusi AL, Ogunsola MO. Prevalence of hallux valgus among youth population in Lagos, Nigeria. Niger Postgrad Med J. 2011;18:51-5.
  4. Bednarz PA, Manoli A 2nd. Modified lapidus procedure for the treatment of hypermobile hallux valgus. Foot Ankle Int. 2000;21:816-21. https://doi.org/10.1177/107110070002101004
  5. Fuhrmann RA. Arthrodesis of the first tarsometatarsal joint for correction of the advanced splayfoot accompanied by a hallux valgus. Oper Orthop Traumatol. 2005;17:195-210. https://doi.org/10.1007/s00064-005-1129-z
  6. Myerson M, Allon S, McGarvey W. Metatarsocuneiform arthrodesis for management of hallux valgus and metatarsus primus varus. Foot Ankle. 1992;13:107-15. https://doi.org/10.1177/107110079201300301
  7. Sangeorzan BJ, Hansen ST Jr. Modified Lapidus procedure for hallux valgus. Foot Ankle. 1989;9:262-6. https://doi.org/10.1177/107110078900900602
  8. Kopp FJ, Patel MM, Levine DS, Deland JT. The modified Lapidus procedure for hallux valgus: a clinical and radiographic analysis. Foot Ankle Int. 2005;26:913-7. https://doi.org/10.1177/107110070502601103
  9. McInnes BD, Bouche RT. Critical evaluation of the modified Lapidus procedure. J Foot Ankle Surg. 2001;40:71-90. https://doi.org/10.1016/S1067-2516(01)80048-X
  10. Rink-Brune O. Lapidus arthrodesis for management of hallux valgus--a retrospective review of 106 cases. J Foot Ankle Surg. 2004;43:290-5. https://doi.org/10.1053/j.jfas.2004.07.007
  11. Lee KT, Young KW, Kim JY, Lee SY. Modified lapidus procedure for the treatment of hallux valgus. J Korean Foot Ankle Soc. 2003;7:179-86.
  12. Willegger M, Holinka J, Ristl R, Wanivenhaus AH, Windhager R, Schuh R. Correction power and complications of first tarsometatarsal joint arthrodesis for hallux valgus deformity. Int Orthop. 2015;39:467-76. https://doi.org/10.1007/s00264-014-2601-x
  13. Albrecht GH. The pathology and treatment of hallux valgus. Russ Vrach. 1911;10:14.
  14. Chuckpaiwong B. Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus. Int Orthop. 2012;36:2275-8. https://doi.org/10.1007/s00264-012-1656-9
  15. Schuh R, Willegger M, Holinka J, Ristl R, Windhager R, Wanivenhaus AH. Angular correction and complications of proximal first metatarsal osteotomies for hallux valgus deformity. Int Orthop. 2013;37:1771-80. https://doi.org/10.1007/s00264-013-2012-4
  16. Smith SE, Landorf KB, Butterworth PA, Menz HB. Scarf versus chevron osteotomy for the correction of 1-2 intermetatarsal angle in hallux valgus: a systematic review and meta-analysis. J Foot Ankle Surg. 2012;51:437-44. https://doi.org/10.1053/j.jfas.2012.02.016
  17. Singh D, Biz C, Corradin M, Favero L. Comparison of dorsal and dorsomedial displacement in evaluation of first ray hypermobility in feet with and without hallux valgus. Foot Ankle Surg. 2016;22:120-4. https://doi.org/10.1016/j.fas.2015.05.014