Modified Lapidus Procedure for the Treatment of Hypermobile Hallux Valgus

Abstract

The intermediate outcome of patients who underwent a modified Lapidus procedure for the treatment of hallux valgus secondary to a hypermobile first ray was evaluated with an outcome tool to determine if their pain and functional status were improved. We evaluated 31 feet in 26 patients who underwent a modified Lapidus procedure. All working patients (100%) returned to full-time work. Six patients were retired and one was unemployed prior to surgery. There was an average of eight months until sports or unlimited activities were performed, and an average 16 weeks until conventional shoes could be worn. All patients but one (96%) were satisfied with the surgery and knowing their results would have the surgery again. Postoperative pain relief satisfaction was totally satisfied in 19 patients, satisfied with reservations in six patients, and not satisfied in one patient. Postoperative appearance satisfaction was totally satisfied in 21 patients and satisfied with reservations in five patients. Postoperative joint motion was no noticeable stiffness in 22 patients, noticeable stiffness but not bothersome in three patients, and stiffness that impairs activity in one patient (two feet). In the radiographic measurements, there was an average improvement of 10 degrees in the hallux valgus angle, 10 degrees in the intermetatarsal angle, two degrees in the lateral metatarsal-floor angle and two grades in the sesamoid position. Complications experienced were five recurrent deformities, two metatarsalgias, and one deep vein thrombosis. One of the five recurrences became symptomatic and required a revision.