Foot and Ankle International - 2026-03-12 - Journal Article
Modified Lambrinudi Combined With X-Shaped Plate Internal Fixation for Triple Arthrodesis.
Li M, Xu Y, Liang X, Xia Y, Wang W, Zhang H, Cheng Y
Topics
Key Takeaway
Modified Lambrinudi triple arthrodesis with X-shaped plate fixation achieved 100% union at 6 months in 14 equinovarus patients, with VAS improving from 6.7 to 1.4 and ICFSG score from 37.7 to 8.1.
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Summary
This retrospective case series evaluated modified Lambrinudi triple arthrodesis with X-shaped plate fixation for rigid equinovarus deformity across mixed etiologies (poliomyelitis, cerebral palsy, post-traumatic, CMT). All 14 patients achieved radiographic union by 6 months, with VAS decreasing from 6.7 to 1.4 (p<0.001) and ICFSG score from 37.7 to 8.1 (p<0.001). An excellent-to-good outcome rate of 93% was reported at mean 46-month follow-up.
Key Limitation
The absence of a comparator fixation group (e.g., screws-only or staple constructs) makes it impossible to attribute the union rate or functional gains to the X-shaped plate specifically rather than the Lambrinudi osteotomy itself.
Original Abstract
BACKGROUND
Equinovarus is a prevalent and debilitating foot deformity requiring surgical intervention when conservative management fails. We performed triple arthrodesis using a modified Lambrinudi combined with X-shaped plate internal fixation to correct deformity, improve gait, and restore walking function, with the primary goal of enhancing the patient's quality of life.
METHODS
This retrospective consecutive case series of 14 patients (mean age, 41.9 ± 15.7 years) aimed to describe clinical/radiographic outcomes and the feasibility of X‑shaped plate fixation within a modified Lambrinudi triple arthrodesis. The patient cohort comprised 4 males and 10 females, with underlying etiologies including poliomyelitis, cerebral palsy, post-traumatic sequelae, and Charcot-Marie-Tooth disease. All patients underwent modified Lambrinudi triple arthrodesis combined with soft tissue procedures. Outcomes were assessed through radiographic evaluation (including the talar-calcaneal angle, talus-first metatarsal angle, and calcaneal-fifth metatarsal angle, all measured on anteroposterior radiographs, along with the lateral talus-first metatarsal angle) and clinical investigations: MOS 36-Item Short-Form Health Survey (SF-36) score, visual analog scale (VAS), and International Clubfoot Study Group (ICFSG) Outcome Evaluation Score.
RESULTS
Mean follow-up time was 46.1 ± 14.8 months (range, 24-69). Radiographic assessment demonstrated bony union in all patients at 6 months following triple arthrodesis. Postsurgical improvements in foot morphology and function occurred at varying levels across the cohort. At last follow-up, marked increases in SF-36 scores were observed in both physical and mental domains, whereas the VAS score decreased from 6.7 to 1.4 ( P < .001) and ICFSG score decreased from 37.7 to 8.1 ( P < .001), with an excellent-to-good rate of 93%.
CONCLUSION
Patients' quality of life improved. Satisfactory fusion rates, favorable clinical outcomes, simple internal fixation requirements were all associated with the modified Lambrinudi procedure with X-shaped plate fixation for triple arthrodesis. This internal fixation is reliable.