Donantoni Marco, Santini Simone, Martinelli Dario, Marinozzi Andrea
Department of Orthopaedic and Trauma Surgery, Fondazione Policlinico Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy.
J Clin Med. 2025 Jun 28;14(13):4591. doi: 10.3390/jcm14134591.
Hallux valgus (HV) is a common forefoot deformity for which numerous surgical techniques have been proposed, with the Lapidus procedure representing a powerful and durable solution, especially in cases of moderate to severe deformities and first ray hypermobility. Initially described in the early 20th century, the Lapidus procedure involves first tarsometatarsal joint (TMTJ) arthrodesis and has undergone multiple modifications over time to reduce complications such as nonunion, malunion, shortening, and recurrence. The technique offers triplanar correction, addressing axial, sagittal, and coronal deformity components. Despite its proven corrective potential, the procedure remains technically demanding, and no universal consensus exists on the ideal fixation method or postoperative protocol. Recent developments in fixation strategies-including crossed screws, locking plates, intramedullary nails, nitinol staples, external fixation, and arthroscopic approaches-have aimed to improve stability, union rates, and the possibility of earlier weight-bearing. This narrative review provides a comprehensive overview of the Lapidus procedure, focusing on surgical indications, technical variants, fixation methods, clinical outcomes, and complications, with the goal of offering practical guidance for optimizing surgical decision-making in various clinical settings.
拇外翻（HV）是一种常见的前足畸形，针对该畸形已提出了多种手术技术，Lapidus手术是一种有效且持久的解决方案，尤其适用于中度至重度畸形以及第一跖骨过度活动的病例。Lapidus手术最初在20世纪初被描述，它涉及第一跗跖关节（TMTJ）融合术，随着时间的推移经历了多次改良，以减少诸如不愈合、畸形愈合、缩短和复发等并发症。该技术提供三维矫正，可解决轴向、矢状面和冠状面的畸形成分。尽管其矫正潜力已得到证实，但该手术在技术上仍要求较高，并且对于理想的固定方法或术后方案尚无普遍共识。固定策略的最新进展——包括交叉螺钉、锁定钢板、髓内钉、镍钛合金钉、外固定和关节镜手术——旨在提高稳定性、融合率以及早期负重的可能性。本叙述性综述全面概述了Lapidus手术，重点关注手术适应症、技术变体、固定方法、临床结果和并发症，目的是为在各种临床环境中优化手术决策提供实用指导。
