{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T02:49:38Z","timestamp":1775443778244,"version":"3.50.1"},"reference-count":8,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPMA"],"abstract":"<jats:p>Background: The Lapidus procedure has become a cornerstone in the surgical management of hallux valgus, especially in cases with associated tarsometatarsal instability. This study investigated and compared the radiographic outcomes of three distinct Lapidus constructs, aiming to provide valuable insights into the optimal fusion configurations for achieving long-term stability improvement and maintaining the intermetatarsal angle (IMA) postoperatively. Methods: In this retrospective study, the objective was to assess and compare the outcomes of three different fusion constructs used in the Lapidus procedure: group 1, transverse screw fixation; group 2, metatarsal cuneiform screw fixation; and group 3, combined transverse and metatarsal cuneiform screw fixation. The study encompassed 32 feet: 11 in group 1, 8 in group 2, and 13 in group 3. The primary focus was to evaluate postoperative stability through radiographic imaging complemented by clinical assessments and an examination of complications. Statistical analyses were used to compare outcomes across the three fixation groups immediately, 3 months, 6 months, and 1 year postoperatively. Results: Radiographic assessments demonstrated successful fusion, and patients reported improvements in pain and function and overall satisfaction with the procedure. Complication rates were within an acceptable range. The IMA in all three groups exhibited a significant reduction postoperatively compared with preoperative measurements. Group 3 demonstrated a notably stronger initial reduction in the IMA compared with groups 1 and 2, and they maintained a statistically significantly more stable IMA value and exhibited a lower recurrence rate compared with the other two groups 1 year postoperatively. Conclusions: These findings endorse the use of Lapidus fusion with these three constructs, particularly with combined transverse and metatarsal cuneiform screw fixation, as a dependable and efficacious surgical approach in addressing hallux valgus with concomitant tarsometatarsal instability.<\/jats:p>","DOI":"10.3390\/japma116020015","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T01:12:33Z","timestamp":1775437953000},"page":"15","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiologic Evaluation and Comparative Analysis of First Metatarsal\u2013Cuneiform Fusion Constructs Assessing Outcomes and Stability Across Varied Fusion Techniques"],"prefix":"10.3390","volume":"116","author":[{"given":"Katherine","family":"Lyons","sequence":"first","affiliation":[{"name":"Trinity Health Livonia Hospital, Livonia, MI 48154, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoang","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Trinity Health Livonia Hospital, Livonia, MI 48154, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelyn","family":"Cleypool","sequence":"additional","affiliation":[{"name":"Trinity Health Livonia Hospital, Livonia, MI 48154, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa R.","family":"Adelman","sequence":"additional","affiliation":[{"name":"Podiatry Medical Education, Providence Hospital, Southfield, MI 48075, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Adelman","sequence":"additional","affiliation":[{"name":"Trinity Health Livonia Hospital, Livonia, MI 48154, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1177\/19386400231164209","article-title":"Radiographic evaluation of first tarsometatarsal joint arthrodesis for hallux valgus deformity: Does the fusion of the first to the second metatarsal base reduce the radiological recurrence rate?","volume":"17","author":"Scheele","year":"2024","journal-title":"Foot Ankle Spec."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1177\/107110070002101004","article-title":"Modified Lapidus procedure for the treatment of hypermobile hallux valgus","volume":"21","author":"Bednarz","year":"2000","journal-title":"Foot Ankle Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"158","DOI":"10.3113\/FAI.2011.0158","article-title":"Fixation of first tarsometatarsal arthrodesis: A retrospective comparative cohort of two techniques","volume":"32","author":"DeVries","year":"2011","journal-title":"Foot Ankle Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2473011421S00901","DOI":"10.1177\/2473011421S00901","article-title":"Intermetatarsal screw fixation reduced intermetatarsal angle following modified Lapidus procedures","volume":"7","author":"Reed","year":"2022","journal-title":"Foot Ankle Orthop."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1177\/1938640016666920","article-title":"Comparison of transverse and coronal plane stability at the first tarsal-metatarsal joint with multiple screw orientations","volume":"10","author":"Feilmeier","year":"2017","journal-title":"Foot Ankle Spec."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1053\/j.jfas.2014.10.008","article-title":"Enhanced Lapidus arthrodesis: Crossed screw technique with middle cuneiform fixation further reduces sagittal mobility","volume":"54","author":"Galli","year":"2015","journal-title":"J. Foot Ankle Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.2106\/JBJS.20.01010","article-title":"Original and modified Lapidus procedures: Proposals for a new terminology","volume":"103","author":"Symeonidis","year":"2021","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/j.jfas.2014.12.019","article-title":"Intraoperative evaluation of medial intercuneiform instability after Lapidus arthrodesis: Intercuneiform hook test","volume":"54","author":"Fleming","year":"2015","journal-title":"J. Foot Ankle Surg."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1930-8264\/116\/2\/15\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T01:43:42Z","timestamp":1775439822000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/116\/2\/15"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,3]]},"references-count":8,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["japma116020015"],"URL":"https:\/\/doi.org\/10.3390\/japma116020015","relation":{},"ISSN":["1930-8264"],"issn-type":[{"value":"1930-8264","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,3]]}}}