Hallux Valgus Correction Utilizing Modified Lapidus Procedure with limited Single proximal incision: Surgeon Series

Abstract Background Hallux valgus represents a prevalent foot deformity that produces both valgus deviation of the proximal phalanx and first metatarsal adduction. The Modified Lapidus Procedure includes arthrodesis of the first tarsometatarsal joint as its main correction method. This research assesses the results of our technique of modified Lapidus procedure performed by a single surgeon with the uses of a limited proximal incision while omitting both distal incision and bunionectomy. Methods This is a retrospective cohort study carried out on 53 patients who had the Lapidus operation performed by a single surgeon in single center between August 2018 and May 2023. 32 participants underwent bunionectomy, while 21 did not. Preoperative and postoperative radiographs were analysed for hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA). The American Orthopaedic Foot and Ankle Society (AOFAS) score was used to evaluate functional results. Results The findings indicated that the mean age of the cohort was 34.74 ± 13.94 years, and majority (94.3%) were female patients. Significant improvements were seen in HVA (35.96° to 14.92°), IMA (16.15° to 6.69°), and DMAA (35.69° to 11.96°). There was no significant difference between Bunionectomy and non-bunionectomy groups in terms of postoperative AOFAS scores. Non-union occurred in 7.5% of patients, and 9.4% required revision surgery with no reported infections. Conclusion Significant functional and radiological improvement in Hallux Valgus Deformity were demonstrate utilizing our technique of modified Lapidus procedure, with low rate of complications. Lapidus procedure effectively lowered HVA, IMA, and DMAA and improved functional and pain scores, regardless of bunionectomy status.