Athanasios Badekas MD, Stamatios Papadakis MD

Hellenic Police Health Department Athens, Greece

Title: Athrodesis of the 1^st metatarsal-cuneiform joint (the modified Lapidus procedure), for correction severe Hallux Valgus deformity.

Hypotheses/Purpose: Severe Hallux Valgus deformity is very difficult to be treated effectively, often is associated with hypermobility of the 1^st ray and is associated with severe metatarsus primus varus therefore fusion of the 1^st metatarso-cuneiform joint is necessary.

Conclusions/Significance: The Lapidus procedure has been effective in treating the hallux valgus deformity associated with severe metatarsus primus varus and hypermobility of the 1^st ray, although is a highly demanding operation.

Methods/Results: 21 Lapidus procedures were performed by the 1^st author in 15 patients with an average follow-up of 19 months in the last 30 months. The average hallux valgus angle was 37 degrees, range (21-74) and was corrected to 13 degrees range (-9 to 23). The average intermetatarsal angle was 15.1 degrees with an average of (10.1 to 35 degrees) and was corrected to an average of 5.7 degrees (range 0 to 13). Complications were 2 non-unions, 2 neuromas of the deep peroneal nerve, 1 dorsal bunion and 1 superficial pin tract infection. Total satisfaction of the patients reached the 83%, 14% were partially relieved, and 3% not relieve with respect to pain, comfort, appearance of the foot and shoe wear following the surgery.