LAPIDUS OSTEOTOMY (TMT1 FUSION)
- Method
- Lapidus osteotomy to stabilise the first ray of the foot
- Duration
- 60 to 90 minutes
- Recovery time
- 8 to 12 weeks
What is a Lapidus osteotomy?
The Lapidus osteotomy is a well-established procedure for treating a pronounced hallux valgus with instability of the first ray of the foot. The joint between the first metatarsal bone (os metatarsale I) and the medial cuneiform (os cuneiforme mediale) is fused surgically (arthrodesis) in order to achieve a stable alignment.
This technique is particularly suited to hypermobility, to a recurrence after previous surgery or to combination with other corrective measures. A Lapidus osteotomy can not only correct the deformity but also take load off the forefoot lastingly.
How the operation proceeds
- Incision over the tarsometatarsal joint
- Precise division of the joint surfaces and correction of the alignment
- Fixation with screws and/or plates
- Combination with an Akin or chevron osteotomy where appropriate
- Soft-tissue balancing for further stabilisation
Rehabilitation after a Lapidus osteotomy
Aftercare following a Lapidus osteotomy takes longer than after other forefoot procedures, because the fusion has to heal completely in the bone first.
Phase I (0-6 weeks): immobilisation and unloading
- Consistent unloading of the foot in a forefoot offloading shoe
- Elevation, cooling, lymphatic drainage
- Regular wound checks and changes of dressing
- No active loading of the arch of the foot
Phase II (6-10 weeks): partial weight-bearing and mobilisation
- Transition to partial weight-bearing once medically cleared
- Beginning physiotherapy with mobilisation of the neighbouring joints
- Activating the muscles of the foot to stabilise the arch
- Gait training under physiotherapy guidance
Phase III (from week 10): building up load and everyday training
- Full weight-bearing in firm footwear once the bone has consolidated
- Strengthening the muscles of the foot and leg
- Sporting activity (for instance cycling, swimming) from week 12-14 at the earliest
- Long-term advice on footwear and insoles where needed
Our Lapidus specialists
Experienced specialists for the Lapidus osteotomy and foot surgery
