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Foot & Ankle
intermediate
X-Type

First TMT Arthrodesis (Lapidus) - Indications and Technique

Forefoot Surgery

A 52-year-old woman presents with moderate hallux valgus with an intermetatarsal angle of 18 degrees and clinical first ray hypermobility. She has failed conservative treatment including wider shoes and orthotics. The surgeon discusses first tarsometatarsal arthrodesis (Lapidus procedure) as a surgical option. Regarding first TMT arthrodesis for hallux valgus:

Mark each as TRUE or FALSE

A

The Lapidus procedure addresses hallux valgus at its apex by fusing the first TMT joint, eliminating...

B

Indications include moderate-severe hallux valgus with IMA greater than 15-16 degrees, first ray hyp...

C

The Lapidus procedure is appropriate for all hallux valgus regardless of severity; distal osteotomie...

D

Key technical principles include complete cartilage removal, correcting IMA with medial translation,...

E

Complications include nonunion (now 2-5% with modern fixation), malunion (dorsiflexion causes transf...

Answer the questions to see explanations

Click T (True) or F (False) for each option