Salvaging Failed Lapidus Fusion Surgery

1

Failed Lapidus procedure of L foot was corrected by syndesmosis procedure together with R foot


Fig.1 Pre-treatment standing x-ray: 13-year old girl with severe left metatarsus primus varus (MPV) deformity of intermetatarsal angle (IMA) at 17.5°.

Fig.2 Early post-Lapidus x-ray: Showing good hallux and sesamoids realignment but mild residual MPV deformity of IMA at 11.7° after a percutaneous procedure.

Fig.3 Post screw-removal x-ray: Showing no noticeable change in deformities of left foot.

Fig.4a Pre-osteodesis photo: Showing bilateral hallux valgus deformity.

Fig.4b Pre-osteodesis photo: Showing calcaneal valgus, pronation and flat foot.

Fig.4c Pre-osteodesis x-ray: Showing solid fusion of left metatarsocuneiform joint. IMA of left foot was slightly increased to 13.1° and right foot to 16°.

Fig.7 6-month postoperative standing x-ray: Showing left IMA of 7.9° and right IMA of 9.1°.

Fig.8a 73-month postoperative photo: Showing normal looking feet and dorsal surgical scars.

Fig.8b 73-month postoperative photo: Showing improved hind foot alignment of both feet.

Fig.8c 73-month postoperative photo: showing strong tip-toeing and free dorsiflexion of metatarsophalangeal joints.

Fig.8d 73-month postoperative standing x-ray: Showing well maintained IMA of left foot at 7.2° and right at 8.7° without signs of recurrence of MPV and HV deformities.


2

Failed Lapidus procedure of L foot was corrected by syndesmosis procedure together with R foot