The modified Lapidus procedure is considered a useful tool for correction of multiplanar deformities in the hallux valgus, including first metatarsal pronation. It offers a greater power of correction compared to most other osteotomies. However, postoperative complications can occur in up to 12% of cases. The aim of this study was to describe intraoperative technical tips in the management of the tarsometatarsal joint during multiplanar correction of severe hallux valgus deformity using the modified Lapidus procedure. It is not the authors' intention to describe a new technique, but to draw attention to intraoperative details in order to prevent complications as nonunion, extension of the first metatarsal and undercorrection of the deformity. Rotational correction of the first metatarsal with adequate bone coaptation of the first metatarsal and the medial cuneiform are the cornerstone for a satisfactory result.Levels of Evidence: Level V, expert opinion.
Keywords: Lapidus; arthrodesis; complications; hallux valgus.