Mr Akram Uddin, Mr John W Bramall, Dr Keng LeongNG, Dr Kajetan Klos, Dr Edgar Roth, Prof Derek Santos
{"title":"改良Lapidus关节融合术后早期负重：104例回顾性分析及术后方案。","authors":"Mr Akram Uddin, Mr John W Bramall, Dr Keng LeongNG, Dr Kajetan Klos, Dr Edgar Roth, Prof Derek Santos","doi":"10.1053/j.jfas.2025.09.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lapidus arthrodesis is indicated for the treatment of first ray dysfunction or hypermobility, hallux valgus (HV) and functional hallux limitus (FHL). Postoperative weightbearing protocols vary amongst surgeons.</p><p><strong>Purpose: </strong>To report radiographic osseous healing and patient-reported outcome measures (PROMS) following a single early weightbearing protocol.</p><p><strong>Study design: </strong>Retrospective review of 104 adults (≥18 years) (104 feet) who underwent open modified Lapidus arthrodesis (without bone graft) by single compression screw and medial locking plate by two surgeons at one centre (between January 2019 to May 2023).</p><p><strong>Methods: </strong>Pre- and postoperative radiographs and electronic records were reviewed for evidence of osseous healing and return to full weightbearing. Secondary measures included deformity reduction and PROMS.</p><p><strong>Results: </strong>At 6-weeks follow-up 98 patients (94%) were confirmed of osseous healing and returned to full weightbearing. Six patients (6%) had delayed osseous healing at 6-weeks but showed signs of osseous healing by 3-months follow-up. Postoperative HV and intermetatarsal angle (IMA) showed significant reduction (mean difference: -12 (SD=8) and -5 (SD=4) degrees respectively; p<0.001 for both). Ten patients (10%) had postoperative complications: hardware irritation 5 (5%), sesamoiditis 2 (2%), hypertrophic scar 2 (2%) and joint stiffness 1 (1%). Eight patients (8%) required further surgery (5 required fixation removal due to hardware irritation. Three underwent either; 1<sup>st</sup> MTPJ open-mobilization, excision of scar or distal metatarsal osteotomy with tibial sesamoid planning). Manchester-Oxford Foot Questionnaire (MOXFQ) showed significant improvement across all domains (mean difference (SD): -51 (SD=22); walking/standing -49 (SD=24); pain -52 (SD=22); and social interaction -51 (SD=28); (p<0.001 for all) with clinically significant effect size (Cohen's d: 2.37; 2.01; 2.37; and 1.84 respectively). Patient satisfaction questionnaire (PSQ-10) score was high mean of 91 (SD=8). 5 patients (5%) were lost by 6-months follow-up.</p><p><strong>Conclusion: </strong>Early weightbearing achieved consistent osseous healing and high PROMS. Larger controlled studies are required to validate these results.</p><p><strong>Level of evidence: </strong>Retrospective study.</p><p><strong>Level iii: </strong></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\":\"Early Weight-bearing Following Modified Lapidus Arthrodesis: A Retrospective Review of 104 Cases & Postoperative Protocol.\",\"authors\":\"Mr Akram Uddin, Mr John W Bramall, Dr Keng LeongNG, Dr Kajetan Klos, Dr Edgar Roth, Prof Derek Santos\",\"doi\":\"10.1053/j.jfas.2025.09.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lapidus arthrodesis is indicated for the treatment of first ray dysfunction or hypermobility, hallux valgus (HV) and functional hallux limitus (FHL). Postoperative weightbearing protocols vary amongst surgeons.</p><p><strong>Purpose: </strong>To report radiographic osseous healing and patient-reported outcome measures (PROMS) following a single early weightbearing protocol.</p><p><strong>Study design: </strong>Retrospective review of 104 adults (≥18 years) (104 feet) who underwent open modified Lapidus arthrodesis (without bone graft) by single compression screw and medial locking plate by two surgeons at one centre (between January 2019 to May 2023).</p><p><strong>Methods: </strong>Pre- and postoperative radiographs and electronic records were reviewed for evidence of osseous healing and return to full weightbearing. Secondary measures included deformity reduction and PROMS.</p><p><strong>Results: </strong>At 6-weeks follow-up 98 patients (94%) were confirmed of osseous healing and returned to full weightbearing. Six patients (6%) had delayed osseous healing at 6-weeks but showed signs of osseous healing by 3-months follow-up. Postoperative HV and intermetatarsal angle (IMA) showed significant reduction (mean difference: -12 (SD=8) and -5 (SD=4) degrees respectively; p<0.001 for both). Ten patients (10%) had postoperative complications: hardware irritation 5 (5%), sesamoiditis 2 (2%), hypertrophic scar 2 (2%) and joint stiffness 1 (1%). Eight patients (8%) required further surgery (5 required fixation removal due to hardware irritation. Three underwent either; 1<sup>st</sup> MTPJ open-mobilization, excision of scar or distal metatarsal osteotomy with tibial sesamoid planning). Manchester-Oxford Foot Questionnaire (MOXFQ) showed significant improvement across all domains (mean difference (SD): -51 (SD=22); walking/standing -49 (SD=24); pain -52 (SD=22); and social interaction -51 (SD=28); (p<0.001 for all) with clinically significant effect size (Cohen's d: 2.37; 2.01; 2.37; and 1.84 respectively). Patient satisfaction questionnaire (PSQ-10) score was high mean of 91 (SD=8). 5 patients (5%) were lost by 6-months follow-up.</p><p><strong>Conclusion: </strong>Early weightbearing achieved consistent osseous healing and high PROMS. Larger controlled studies are required to validate these results.</p><p><strong>Level of evidence: </strong>Retrospective study.</p><p><strong>Level iii: </strong></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.2025.09.001\",\"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.2025.09.001","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Early Weight-bearing Following Modified Lapidus Arthrodesis: A Retrospective Review of 104 Cases & Postoperative Protocol.
Background: Lapidus arthrodesis is indicated for the treatment of first ray dysfunction or hypermobility, hallux valgus (HV) and functional hallux limitus (FHL). Postoperative weightbearing protocols vary amongst surgeons.
Purpose: To report radiographic osseous healing and patient-reported outcome measures (PROMS) following a single early weightbearing protocol.
Study design: Retrospective review of 104 adults (≥18 years) (104 feet) who underwent open modified Lapidus arthrodesis (without bone graft) by single compression screw and medial locking plate by two surgeons at one centre (between January 2019 to May 2023).
Methods: Pre- and postoperative radiographs and electronic records were reviewed for evidence of osseous healing and return to full weightbearing. Secondary measures included deformity reduction and PROMS.
Results: At 6-weeks follow-up 98 patients (94%) were confirmed of osseous healing and returned to full weightbearing. Six patients (6%) had delayed osseous healing at 6-weeks but showed signs of osseous healing by 3-months follow-up. Postoperative HV and intermetatarsal angle (IMA) showed significant reduction (mean difference: -12 (SD=8) and -5 (SD=4) degrees respectively; p<0.001 for both). Ten patients (10%) had postoperative complications: hardware irritation 5 (5%), sesamoiditis 2 (2%), hypertrophic scar 2 (2%) and joint stiffness 1 (1%). Eight patients (8%) required further surgery (5 required fixation removal due to hardware irritation. Three underwent either; 1st MTPJ open-mobilization, excision of scar or distal metatarsal osteotomy with tibial sesamoid planning). Manchester-Oxford Foot Questionnaire (MOXFQ) showed significant improvement across all domains (mean difference (SD): -51 (SD=22); walking/standing -49 (SD=24); pain -52 (SD=22); and social interaction -51 (SD=28); (p<0.001 for all) with clinically significant effect size (Cohen's d: 2.37; 2.01; 2.37; and 1.84 respectively). Patient satisfaction questionnaire (PSQ-10) score was high mean of 91 (SD=8). 5 patients (5%) were lost by 6-months follow-up.
Conclusion: Early weightbearing achieved consistent osseous healing and high PROMS. Larger controlled studies are required to validate these results.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
