Ramy Samargandi, Aimery Sabelle, Jean Brilhault, Julien Berhouet, Rayane Benhenneda
{"title":"分离改良Lapidus手术能改变后足对中吗?回顾性影像学研究。","authors":"Ramy Samargandi, Aimery Sabelle, Jean Brilhault, Julien Berhouet, Rayane Benhenneda","doi":"10.1053/j.jfas.2025.09.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate the effect of first tarsometatarsal joint (TMT-1) arthrodesis using the modified Lapidus procedure on coronal hindfoot alignment, given the potential influence of medial column stabilization on talar positioning.</p><p><strong>Study design: </strong>A retrospective radiographic analysis was performed.</p><p><strong>Methods: </strong>We reviewed 54 feet in 40 patients (mean age 60.6 ± 9.78 years) who underwent an isolated modified Lapidus procedure with an average follow-up of 29.6 ± 13.9 months. Fixation was achieved using a compression screw and plantar plate. Preoperative and 12-month postoperative weight-bearing dorsoplantar, lateral, and Méary views were analyzed. Radiographic measurements were independently performed by two senior surgeons and assessed for inter-observer reliability. Importantly, only radiographic outcomes were evaluated.</p><p><strong>Results: </strong>On Méary view, hindfoot valgus decreased significantly using the Méary's circle angle method (-2.0 ± 2.0° for observer 1 and -2.44 ± 1.84° for observer 2; p < 0.001 for both). Djian's hindfoot valgus angle also decreased significantly (-1.44 ± 0.98°, p < 0.001 for observer 1; -1.67 ± 4.09°, p = 0.004 for observer 2). Inter-observer reliability was good (ICC = 0.87 and 0.80, respectively).</p><p><strong>Conclusion: </strong>The modified Lapidus procedure resulted in a significant radiographic reduction in hindfoot valgus, suggesting a stabilizing effect on the medial column and hindfoot. These radiographic findings may inform surgical planning in patients with hallux valgus and concomitant flatfoot, although further clinical validation is required.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Can an Isolated Modified Lapidus Procedure Alter Hindfoot Alignment? A Retrospective Radiographic Study.\",\"authors\":\"Ramy Samargandi, Aimery Sabelle, Jean Brilhault, Julien Berhouet, Rayane Benhenneda\",\"doi\":\"10.1053/j.jfas.2025.09.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The study aimed to evaluate the effect of first tarsometatarsal joint (TMT-1) arthrodesis using the modified Lapidus procedure on coronal hindfoot alignment, given the potential influence of medial column stabilization on talar positioning.</p><p><strong>Study design: </strong>A retrospective radiographic analysis was performed.</p><p><strong>Methods: </strong>We reviewed 54 feet in 40 patients (mean age 60.6 ± 9.78 years) who underwent an isolated modified Lapidus procedure with an average follow-up of 29.6 ± 13.9 months. Fixation was achieved using a compression screw and plantar plate. Preoperative and 12-month postoperative weight-bearing dorsoplantar, lateral, and Méary views were analyzed. Radiographic measurements were independently performed by two senior surgeons and assessed for inter-observer reliability. Importantly, only radiographic outcomes were evaluated.</p><p><strong>Results: </strong>On Méary view, hindfoot valgus decreased significantly using the Méary's circle angle method (-2.0 ± 2.0° for observer 1 and -2.44 ± 1.84° for observer 2; p < 0.001 for both). Djian's hindfoot valgus angle also decreased significantly (-1.44 ± 0.98°, p < 0.001 for observer 1; -1.67 ± 4.09°, p = 0.004 for observer 2). Inter-observer reliability was good (ICC = 0.87 and 0.80, respectively).</p><p><strong>Conclusion: </strong>The modified Lapidus procedure resulted in a significant radiographic reduction in hindfoot valgus, suggesting a stabilizing effect on the medial column and hindfoot. These radiographic findings may inform surgical planning in patients with hallux valgus and concomitant flatfoot, although further clinical validation is required.</p>\",\"PeriodicalId\":50191,\"journal\":{\"name\":\"Journal of Foot & Ankle Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Foot & Ankle Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1053/j.jfas.2025.09.002\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Foot & Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jfas.2025.09.002","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Can an Isolated Modified Lapidus Procedure Alter Hindfoot Alignment? A Retrospective Radiographic Study.
Purpose: The study aimed to evaluate the effect of first tarsometatarsal joint (TMT-1) arthrodesis using the modified Lapidus procedure on coronal hindfoot alignment, given the potential influence of medial column stabilization on talar positioning.
Study design: A retrospective radiographic analysis was performed.
Methods: We reviewed 54 feet in 40 patients (mean age 60.6 ± 9.78 years) who underwent an isolated modified Lapidus procedure with an average follow-up of 29.6 ± 13.9 months. Fixation was achieved using a compression screw and plantar plate. Preoperative and 12-month postoperative weight-bearing dorsoplantar, lateral, and Méary views were analyzed. Radiographic measurements were independently performed by two senior surgeons and assessed for inter-observer reliability. Importantly, only radiographic outcomes were evaluated.
Results: On Méary view, hindfoot valgus decreased significantly using the Méary's circle angle method (-2.0 ± 2.0° for observer 1 and -2.44 ± 1.84° for observer 2; p < 0.001 for both). Djian's hindfoot valgus angle also decreased significantly (-1.44 ± 0.98°, p < 0.001 for observer 1; -1.67 ± 4.09°, p = 0.004 for observer 2). Inter-observer reliability was good (ICC = 0.87 and 0.80, respectively).
Conclusion: The modified Lapidus procedure resulted in a significant radiographic reduction in hindfoot valgus, suggesting a stabilizing effect on the medial column and hindfoot. These radiographic findings may inform surgical planning in patients with hallux valgus and concomitant flatfoot, although further clinical validation is required.
期刊介绍:
The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.