How the Lapidus Has Evolved
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What are the most important points listeners should take from your presentation?
The most important points to take from the presentation are that the Lapidus bunionectomy continues to evolve over the years and continues to advance for the better. We should always look at ways to master the procedure but need to understand the past/basics to be able to get better.
How have Lapidus techniques evolved over the years?
Most recently since the ‘80s it has been hardware and cut guides. Previously surgeons used suture material before internal hardware was in use. There have also been studies about relative stability versus absolute stability.1–4 The big question has been when to weight-bear on Lapidus procedure.
How do you see the Lapidus evolving in the future?
I see more and more physicians moving toward minimally invasive types of surgery. I can see smaller and smaller incisions for Lapidus type of surgery and also pushing the limit on when to weight-bear and get patients back to normal shoes.
Nicholas R. Butler, DPM, AACFAS, FACPM, FASPS, is an Assistant Professor in the College of Podiatric Medicine in the Division of Clinical Medicine and Surgery at Kent State University.
Reference
1. Drummond D, Motley T, Kosmopoulos V, Ernst J. Stability of locking plate and compression screws for Lapidus arthrodesis: a biomechanical comparison of plate position. J Foot Ankle Surg. 2018;57(3):466-470. doi:10.1053/j.jfas.2017.10.025
2. King CM, Castellucci-Garza FM. The Lapidus bunionectomy revolution: current concepts and considerations. Clin Podiatr Med Surg. 2024;41(1):43-58. doi:10.1016/j.cpm.2023.06.002.
3. Lapidus PW. The operative correction of the metatarsus varus primus in hallux valgus. Surg Gynecol Obstet. 1934;58:183-91.
4. Symeonidis PD, Anderson JG. Original and modified Lapidus procedures: proposals for a new terminology. J Bone Joint Surg Am. 2021;103(4):e15. doi:10.2106/JBJS.20.01010
