The change of first metatarsal head articular surface position after Lapidus arthrodesis
Abstract Background The Lapidus procedure has been used for hallux valgus deformity correction since 1931. In some cases, the arthrodesis results in an unfavourable lateral inclination of first metatarsal head articular surface. The objective of our study was to evaluate the change of orientation of...
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BMC
2018-09-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-018-2262-9 |
| _version_ | 1828802210481307648 |
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| author | Jan Klouda Rastislav Hromádka Simona Šoffová Stanislav Popelka Stanislav Popelka Ivan Landor |
| author_facet | Jan Klouda Rastislav Hromádka Simona Šoffová Stanislav Popelka Stanislav Popelka Ivan Landor |
| author_sort | Jan Klouda |
| collection | DOAJ |
| description | Abstract Background The Lapidus procedure has been used for hallux valgus deformity correction since 1931. In some cases, the arthrodesis results in an unfavourable lateral inclination of first metatarsal head articular surface. The objective of our study was to evaluate the change of orientation of this articular surface in relation to the second metatarsal axis by comparing pre- and postoperative radiographs. The secondary target was to evaluate possible benefits of combination of Lapidus and Akin procedures in the reduction of hallux valgus deformity. Methods We evaluated 449 pre- and postoperative radiographs of 134 operations from 2010 to 2015. Routinely used angle measurements were performed on all X-rays. A sum of tangential angle to the second axis and distal articular set angle values was chosen as the best indicator for the deformity correction success. Results The mean value of these angles total was 5.2° ±9.3° before and 14.2° ±7.8° after the operation. In the group of patients, where the additional Akin osteotomy was used, the mean value was 5.3° ±8.4° before and 6.9° ±10.2° after the surgery. The mean difference in values between the two groups (with and without Akin procedure) was 7.3° of extra correction in favour of the group with the Akin osteotomy. Conclusions The mean worsening of the tangential angle after Lapidus operation was 6.1° ±6.9°, which counts for significant deterioration after a surgery. The Akin osteotomy was found to be a valuable addition to the Lapidus arthrodesis, which improves the position of articular surfaces in first metatarsophalangeal joint. |
| first_indexed | 2024-12-12T07:00:05Z |
| format | Article |
| id | doaj.art-efb9adf910a540eab0a19a5ad575acf6 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-12T07:00:05Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-efb9adf910a540eab0a19a5ad575acf62022-12-22T00:33:52ZengBMCBMC Musculoskeletal Disorders1471-24742018-09-011911710.1186/s12891-018-2262-9The change of first metatarsal head articular surface position after Lapidus arthrodesisJan Klouda0Rastislav Hromádka1Simona Šoffová2Stanislav Popelka3Stanislav Popelka4Ivan Landor5Department of Orthopaedics, Hospital Nemocnice České Budějovice, a.s.Department of Orthopaedics, First Faculty of Medicine, Charles University and Motol University HospitalInstitute of Anatomy, First Faculty of Medicine, Charles UniversityDepartment of Orthopaedics, First Faculty of Medicine, Charles University and Motol University HospitalDepartment of Orthopaedics, First Faculty of Medicine, Charles University and Motol University HospitalDepartment of Orthopaedics, First Faculty of Medicine, Charles University and Motol University HospitalAbstract Background The Lapidus procedure has been used for hallux valgus deformity correction since 1931. In some cases, the arthrodesis results in an unfavourable lateral inclination of first metatarsal head articular surface. The objective of our study was to evaluate the change of orientation of this articular surface in relation to the second metatarsal axis by comparing pre- and postoperative radiographs. The secondary target was to evaluate possible benefits of combination of Lapidus and Akin procedures in the reduction of hallux valgus deformity. Methods We evaluated 449 pre- and postoperative radiographs of 134 operations from 2010 to 2015. Routinely used angle measurements were performed on all X-rays. A sum of tangential angle to the second axis and distal articular set angle values was chosen as the best indicator for the deformity correction success. Results The mean value of these angles total was 5.2° ±9.3° before and 14.2° ±7.8° after the operation. In the group of patients, where the additional Akin osteotomy was used, the mean value was 5.3° ±8.4° before and 6.9° ±10.2° after the surgery. The mean difference in values between the two groups (with and without Akin procedure) was 7.3° of extra correction in favour of the group with the Akin osteotomy. Conclusions The mean worsening of the tangential angle after Lapidus operation was 6.1° ±6.9°, which counts for significant deterioration after a surgery. The Akin osteotomy was found to be a valuable addition to the Lapidus arthrodesis, which improves the position of articular surfaces in first metatarsophalangeal joint.http://link.springer.com/article/10.1186/s12891-018-2262-9Hallux valgusLapidus arthrodesisAkin osteotomyTangential angle to the second axisProximal articular set angleX-ray analysis |
| spellingShingle | Jan Klouda Rastislav Hromádka Simona Šoffová Stanislav Popelka Stanislav Popelka Ivan Landor The change of first metatarsal head articular surface position after Lapidus arthrodesis BMC Musculoskeletal Disorders Hallux valgus Lapidus arthrodesis Akin osteotomy Tangential angle to the second axis Proximal articular set angle X-ray analysis |
| title | The change of first metatarsal head articular surface position after Lapidus arthrodesis |
| title_full | The change of first metatarsal head articular surface position after Lapidus arthrodesis |
| title_fullStr | The change of first metatarsal head articular surface position after Lapidus arthrodesis |
| title_full_unstemmed | The change of first metatarsal head articular surface position after Lapidus arthrodesis |
| title_short | The change of first metatarsal head articular surface position after Lapidus arthrodesis |
| title_sort | change of first metatarsal head articular surface position after lapidus arthrodesis |
| topic | Hallux valgus Lapidus arthrodesis Akin osteotomy Tangential angle to the second axis Proximal articular set angle X-ray analysis |
| url | http://link.springer.com/article/10.1186/s12891-018-2262-9 |
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