Abe Jun, Higuchi Junya, Wakayama Daiki, Miki Yuji, Matsuzaki Yukari, Yasui Tetsuro
Department of Orthopaedic Surgery, Teikyo University Mizonokuchi Hospital, 5-1-1 Futago, Takatsu-ku, Kawasaki-shi, Kanagawa 213-8507, Japan.
Department of Orthopaedic Surgery, Teikyo University Mizonokuchi Hospital, 5-1-1 Futago, Takatsu-ku, Kawasaki-shi, Kanagawa 213-8507, Japan.
Int J Surg Case Rep. 2025 Jun;131:111442. doi: 10.1016/j.ijscr.2025.111442. Epub 2025 May 14.
Hallux valgus is a common foot deformity often associated with first tarsometatarsal (TMT) joint instability. The Lapidus procedure, involving first TMT joint arthrodesis, is a well-established surgical procedure for severe cases, but the issue lies in the method of fixation. The InCore® Lapidus System is a novel intramedullary fixation system for modified Lapidus procedure. We here report the clinical experience of this system.
We retrospectively reviewed four cases who underwent a modified Lapidus procedure using the InCore® Lapidus System and followed up at least 6 months. Surgical outcomes were evaluated by the hallux valgus (HV) and intermetatarsal (M1M2) angles on radiographs, bone union status on computed tomography (CT), postoperative pain levels, and the occurrence of complications. The HV angle improved in all four cases, ranging from 51° to 59° preoperatively and decreasing to 4° to 25° at the final follow-up. Similarly, the M1M2 angle improved in all four cases, with values decreasing from a preoperative range of 23° to 26° to a final range of 4° to 13°. All patients achieved bone union within three months, and postoperative pain was minimal (Numerical Rating Scale: 0-1) at six weeks postoperatively. No complications were observed.
Theoretical advantages of the InCore® Lapidus System include the ability to achieve joint compression using the device and the intramedullary fixation design, which may provide robust stability and a high rate of bone union. The system's design potentially reduces the risk of skin irritation, a common issue with plate fixation. Our clinical experiences supported these theoretical advantages.
The modified Lapidus procedure using the InCore® Lapidus System provided favorable short-term outcomes for hallux valgus without complications.
拇外翻是一种常见的足部畸形，常与第一跖楔关节不稳定相关。Lapidus手术，即第一跖楔关节融合术，是治疗严重病例的一种成熟的外科手术，但问题在于固定方法。InCore® Lapidus系统是一种用于改良Lapidus手术的新型髓内固定系统。我们在此报告该系统的临床经验。
我们回顾性分析了4例行改良Lapidus手术并使用InCore® Lapidus系统的患者，随访时间至少6个月。通过X线片上的拇外翻（HV）角和跖间（M1M2）角、计算机断层扫描（CT）上的骨愈合情况、术后疼痛程度以及并发症的发生情况来评估手术效果。所有4例患者的HV角均得到改善，术前范围为51°至59°，末次随访时降至4°至25°。同样，所有4例患者的M1M2角也得到改善，数值从术前的23°至26°降至末次随访时的4°至13°。所有患者均在3个月内实现骨愈合，术后6周时疼痛轻微（数字评分量表：0 - 1）。未观察到并发症。
InCore® Lapidus系统的理论优势包括使用该装置实现关节加压的能力以及髓内固定设计，这可能提供强大的稳定性和较高的骨愈合率。该系统的设计可能降低皮肤刺激的风险，而皮肤刺激是钢板固定常见的问题。我们的临床经验支持了这些理论优势。
使用InCore® Lapidus系统的改良Lapidus手术为拇外翻提供了良好的短期效果，且无并发症。
