In a 1st tarsometatarsal (TMT) joint arthrodesis, there is a risk of over shortening the first ray due to over-resection of bone or an inherently short first ray. Attempting to create cuts to achieve the precise amount of IM correction while simultaneously creating congruent surfaces to promote bony apposition at the fusion site can be technically challenging. Avoiding plantar gapping by removing the plantar cartilage from the soft tissue attachments can also prove difficult. Dorsiflexion of the first ray can occur during joint preparation as well, which can lead to transfer metatarsalgia.
The Paragon 28® Lapidus Cut Guide System addresses these concerns by giving the surgeon eight different options for the desired amount of IM correction, while reproducibly guiding cuts through the entirety of the joint resulting in congruent and accurate cartilage removal that minimizes the chance of over-resection. A built in dorsal to plantar taper on cuts made on the metatarsal in two different guide variations is offered to reduce the likelihood of first ray dorsiflexion intraoperatively.