Department of Orthopaedics, Foot and Ankle Surgery, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil.
Department of Orthopaedic Surgery, Foot and Ankle Surgery, Clínica de Ortopedia e Traumatologia Ortocity, São Paulo, SP, Brazil.
Foot Ankle Spec. 2023 Apr;16(2):159-167. doi: 10.1177/19386400221118884. Epub 2022 Aug 21.
The modified Lapidus procedure (MLP), which consists of fusion between the first metatarsal (M1) and medial cuneiform, has been widely performed with satisfactory clinical outcomes, but it has a variable nonunion rate ranging between 4% and 10% and loss of correction in up to 5.8% of the cases. Excessive motion around the site of tarsometatarsal arthrodesis, specially at the intercuneiform joint, is probably the reason. The original Lapidus procedure (OLP), which includes fusion of the M1 to second metatarsal (M2), may be beneficial in preventing nonunion and recurrence. The objective of this study was to describe intraoperative technical tips in the OLP to improve M1 to M2 fusion, which may prevent complications. Since the Lapidus procedure continues to gain popularity, it is the authors opinion that the OLP requires special attention because it is a more technically demanding surgery compared to the MLP. Level V: Expert opinion.
改良Lapidus 手术（MLP），即第一跖骨（M1）与内侧楔骨融合，已广泛应用于临床，取得了满意的效果，但仍有 4%至 10%的不愈合率，多达 5.8%的病例出现矫正丢失。跗跖关节融合处（特别是在中间楔骨关节处）过度活动可能是导致这种情况的原因。而原始 Lapidus 手术（OLP），即 M1 与第二跖骨（M2）融合，可能有助于预防不愈合和复发。本研究的目的是描述 OLP 术中的技术要点，以改善 M1 与 M2 的融合，从而预防并发症。由于 Lapidus 手术仍在普及，作者认为 OLP 需要特别关注，因为与 MLP 相比，它是一种技术要求更高的手术。证据级别：专家意见。
