Lapifuse Flashcards
What is lapifuse?
A “Triplanar Correction” system to correct foot deformities caused by bunions
3 benefits of lapifuse?
- Improved appearance
- Pain reduction
- Improved mobility
How does the lapifuse procedure work? 4 steps summarized
- Surgeon will make a few small incisions to expose the affected joint
- Remove cartilage.
- Rotate the first mtp joint to return it to its proper alignment
- Secure correction - titanium plates screwed into the joint.
Define triplane correction
Correcting the deformities in all 3 cardinal planes; Transverse plane, saggital plane, and frontal plane
What is the lapidus procedure able to correct 3 things on planes
Surgeons are able to correct the intermetatarsal 1-2 angle (transverse plane) , hyper mobility (saggital plane) , and the sessamoid position and rotation of the metatarsal (frontal plane).
3 different planes
Transverse, frontal, saggital
Foot anatomy
Define sasamoid position
A bone embedded in a tendon. 2 pea shaped bones in the ball of the foot beneath the big toe
Physical exam, what do we look for to perform lapidus procedure?
First ray- hyper mobility ( increased arc of motion) 5mm
Transverse, saggital plane excursion ( range of movement)
Summary of what to look at to perform lapidus - 4 things
- Detailed clinical and radio graphic exam
- Joint congruency ( joint inspection) - degerative changes at first metatarsal
- Mild, moderate, or severe bunion
- Age
Lapidus is time tested and reproducible , no significant recurrence
Tmt joint
The connections between the tarsals and metatarsals in the middle of the foot
Lapifuse system pieces
Joint prep kit, Triplanar clamp, lapifuse targeting guide, standard & trans-metatarsal titanium plates
plate options
- Standard, 5 hole 0mm & 2mm step
- Trans-metatarsal 6 hole 0mm & 2mm step
Both available in right & left
All plates have how many locking holes
All plates have 2 locking holes for proximal fixation, and 2 locking holes for distal fixation.
All plates have a compression slot
The 6 hole trans-metatarsal plate has an second metatarsal locking hole for additional stability
Screws
Laifuse system includes 3.5mm diameter locking . and non locking screws,
Ranging from 12mm to 40mm in 2mm increments
Interfragmentary (cross) Screw
Available in screw lengths from 35mm to 45mm in 2.5mm increments
Single diameter of 4.0mm
First screw put in at angle from first metatarsal to medial cuneiform to body of intermediate cuneiform.
Joint prep kit pieces
Single use osteotome
Curette
25mm drill
Lapifuse clamp
Clamp
Ratcheting feature
Hook
Lapifuse targeting guide
targeting guide uses fluoroscopic feedback for visualization of the inter fragmentary screw placement
