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Titre : | Evolution of Thinking of the Lapidus Procedure and Fixation (2020) |
Auteurs : | Shuyuan Li |
Type de document : | Article |
Dans : | Foot and Ankle Clinics (Vol. 25, n° 1, Mars 2020) |
Article en page(s) : | p. 109-126 |
Note générale : | https://doi.org/10.1016/j.fcl.2019.11.001 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Arthrose ; Hallux valgus ; Instabilité articulaire ; Plaque plantaire |
Mots-clés: | Procédure Lapidus ; Fixation |
Résumé : |
- The Lapidus procedures have been widely used in treating many forefoot and midfoot deformities associated with first tarsometatarsal joint dysfunction, including primary hallux valgus, recurrent hallux valgus, metatarsal adductus, lesser metatarsalgia, and midfoot arthritis, because the Lapidus procedures have the ability to restore the first ray alignment in 3 dimensions.
- Choosing between a traditional and a modified Lapidus procedure is based on whether the sagittal or the transverse plane motion between the first and second rays is acceptable or not. Too much mobility in either plane can lead to recurrent deformity, and it is suggested to start with a modified Lapidus and reevaluate the stability of the first ray and motion between the medial and middle cuneiform on stress views under fluoroscopy. If there is any intercuneiform instability, then proceeding to a true Lapidus procedure is necessary. - Nonunion, malunion, and shortening have been worrisome complications of the Lapidus procedures for decades. However, with the progress in understanding of the anatomy, function, and biomechanical characteristics of the first tarsometatarsal joint, substantial development in both surgical approaches and new fixation techniques has been made. Some fixation methods, such as a plantar plate, nitinol staples, and intramedullary fixation, have been proven to be stronger biomechanically in cadaveric studies. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S1083751519301330 |