• 대한족부족관절학회지
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• 제7권2호
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• pp.179-186
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• 2003

Purpose: The purpose of this study was to evaluate the result of modified Lapidusprocedure for Hallux valgus associated with first ray hypermobility Materials and Methods: A retrospective study was conducted between Aug. 1999 and Oct. 2003. We evaluated 20 cases (12patients)of hallux valgus that performed modified Lapidus procedure. We asked to patient about postoperative satisfaction in terms of overall, pain, and appearance. preoperative and postoperative AOFAS score for the forefoot was calculated, also preoperative and postoperative radiologic evaluation was done. Results: In terms of satifaction, overall rate was 70%, pain relief and appearance were 70% and 70%. preoperative mean Hallux valgus angle and mean intermetatarsal angle were 42.6degree and 19.4degree. after procedure, at last follow up, mean hallux valgus angle and mean intermetatarsal angle were 16degree and 8.7degree. In terms of complication, nonunion was seen in 3 cases and recurrence of hallux valgus deformity was 2 cases. Conclusion: In consideration of high complication rate, modified Lapidus prociduremust be improved in terms of more rigid fixation technique, etc.

• 대한족부족관절학회지
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• 제21권3호
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• pp.88-92
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• 2017

Purpose: The objective of this study was to confirm the results of the modified Lapidus procedure on moderate to severe hallux valgus patients with first tarso-metatarsal joint hypermobility. Materials and Methods: A retrospective study was conducted on 42 cases of 35 patients who underwent the modified Lapidus procedure between March 2006 and December 2014. A comparative analysis was performed on the preoperative and postoperative subjective satisfaction of patients and radiologic index. Moreover, the correlation between the follow-up time and patient's operative satisfaction, as well as between the proficiency of the operator and patient's operative satisfaction was analyzed. Complications were also evaluated. Results: Out of the total of 35 patients, 3 were male and 32 were female. The mean age was 61.3 years (range, 34~79 years), and the mean follow-up time was 22.1 months (range, 6~90 months). The overall satisfaction level was 67.6% and the mean hallux valgus angle improved from preoperative $40.5^{\circ}$ to postoperative $12.2^{\circ}$ (p<0.001). The mean 1, 2 intermetatarsal angle improved from preoperative mean of $16.9^{\circ}$ to postoperative mean of $7.6^{\circ}$ (p<0.001), and the sesamoid position improved significantly, from preoperative 2.7 to postoperative 0.9 (p<0.001). Furthermore, there was no correlation between the follow-up time and the American Orthopaedic Foot and Ankle Society (AOFAS) hallux scale; also no correlation between the year the operation took place and the AOFAS hallux scale. In terms of complications, we observed screw irritation in 6 cases, hallux varus in 2 cases, and recurrence of hallux valgus and nonunion in one case. Conclusion: Contrary to our concerns, the level of complications was not high; however, the satisfaction level of patients was also not very high. Therefore, careful selecting of patients and sufficient consultation time is needed before surgery. In addition, since the causes of postoperative dissatisfaction still remain unclear, further studies are necessary.

• 대한족부족관절학회지
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• 제23권4호
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• pp.143-148
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• 2019

Although many patients who undergo bunion repair do well and have satisfactory results, a critical evaluation of these results shows the potential for improvement. Metatarsal deformity of the hallux valgus is a 3-dimensional deformity, including rotation in the coronal plane. Theoretically, it is important to understand the 3-dimensional displacement of the first metatarsal for correcting the deformities of valgus rotation in the frontal plane. Yet the current methods of metatarsal osteotomy principally attempt to correct the deformity in the transverse plane. The modified technique for the Lapidus procedure can be used in a variety of hallux valgus conditions and severities, and the early results suggest that a powerful correction can be maintained. In addition, efforts have been made to correct the 3-dimensional deformity by performing metatarsal shaft osteotomy. In the case of degenerative arthritis, first metatarsophalangeal joint arthrodesis is a good option to correct the 3-dimensional deformation. Correction of the 3-dimensional deformity, including a rotational deformity in the frontal plane of the metatarsals, should be considered when selecting surgical treatment and is essential for achieving a good prognosis for patients with hallux valgus. This article reviews the classification and treatment of hallux valgus for correction of the 3-dimensional deformity.