Modified Lambrinudi Combined With X-Shaped Plate Internal Fixation for Triple Arthrodesis

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.