Case report highlights progressive intercuneiform instability despite successful tarsometatarsal fusion, suggesting need for supplemental fixation.
Case: A 78-year-old man with osteoarthritis and progressive hallux valgus underwent triplanar first tarsometatarsal (TMT) arthrodesis using the Lapiplasty system. Despite successful fusion, postoperative radiographs demonstrated progressive intercuneiform diastasis with recurrence of deformity and midfoot discomfort. Conclusion: Intercuneiform instability may progress despite successful first TMT fusion and adjunct intercuneiform stabilization. In cases of ligamentous insufficiency, fixation alone may be inadequate, and supplemental intercuneiform fixation or arthrodesis should be considered.
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Marzook et al. (2026) studied this question.
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