Modified Lapidus Procedure with a Nitinol Staple and Two Screw Construct Technique.

Abstract

Many fixation options exist for correction of a hallux valgus (HV) deformity with a first tarsometatarsal (TMT) joint arthrodesis with pros and cons to each. Few have looked at utilizing a SMA (shape memory alloy) staple made from nitinol for fixation. This study evaluates the effectiveness of a modified Lapidus technique using a nitinol (shape memory alloy) staple combined with a two-screw construct for first tarsometatarsal (TMT) joint arthrodesis in correcting hallux valgus (HV) deformity. The non-union rate, time to weightbearing in both a boot and a shoe, hardware removal of the staples, and the need for revision surgeries were all evaluated. A retrospective review of 42 patients meeting the inclusion criteria was conducted, with an average follow-up time of 12.3 months (SD 4.5). Bony union was achieved in 47 of 48 (97.92%) cases for a non-union rate of 2.08%. The average time to weightbearing in a boot was 27.35 days (SD 3.47), while in a shoe, it was 55.58 days (SD 10.03). There was a total of 3 procedures requiring staple removal (3/48) (6.25%), and no revision surgeries were needed due to loss of correction or non-union. These outcomes suggest that the nitinol staple and two-screw construct is a reliable option for first tarsometatarsal joint arthrodesis in hallux valgus deformity, showing similar results compared to other fixation methods. Level of Clinical Evidence: 4.