Arthrodesis of the first metatarsocuneiform joint: a comparative study of fixation methods

Foot Ankle Int. 2009 Apr;30(4):341-5. doi: 10.3113/FAI.2009.0341.


Background: The Lapidus bunionectomy is a popular procedure for severe bunion deformity where metatarsus primus varus is equal to or exceeds 15 degrees. We evaluated a new locking compression plate which may improve outcomes with the Lapidus procedure.

Methods: Ten matched pairs of cadaver feet were used to compare the standard crossed 4.0-mm compression screw method of fixation to the LPS Lapidus plate. After performing the matched operations the cadaver constructs were stressed to failure using the INSTRON and Wavemaker software.

Results: The LPS Lapidus plate load to failure was 108 Nm with a bending moment of 6.0 Nm. The crossed screw technique was inferior at 78 Nm with a bending moment of 4.4 Nm (p = 0.02)

Conclusion: Unlike other H-plates or locking plates, load to failure was higher with the Lapidus plate constructs.

Clinical relevance: The increased rigidity provided by these plates may help to minimize the risk of nonunion or malunion.

Publication types

  • Comparative Study

MeSH terms

  • Arthrodesis / instrumentation*
  • Bone Plates*
  • Bone Screws
  • Cadaver
  • Equipment Failure Analysis
  • Foot Joints*
  • Hallux Valgus / surgery*
  • Humans
  • Prosthesis Design
  • Range of Motion, Articular
  • Weight-Bearing