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General Orthopaedics

The Lapidus Procedure

The South African Orthopaedic Association (SAOA) 57th Annual Congress



Abstract

Purpose:

To describe a plating technique for the Lapidus procedure as an alternative to the traditional screw fixation technique. To look at the complications experienced during the Lapidus procedure and to find possible solutions to prevent these complications.

Methods:

A retrospective study of 34 Lapidus procedures in 26 patients (8 bilateral) between 2006 and 2009 was performed. All were done with a plating technique and a primary bone graft.

The indications were:

  • metatarsus primus varus

  • hypermobility

  • degenerative TMT joint

Results:

The average intermetatarsal angle pre-operatively was 17.1° and this was reduced to 6,4° post – operatively.

The complications experienced were:

  • post –operative metal removal = 6

  • transfer metatarsalgia = 1

  • hallux varus = 1

  • screw breakage = 1

  • delayed union = 1

  • non-union = 1

Conclusion:

The plating technique for the Lapidus procedure gives stable fixation and the outcome compares well with other methods of fixation.