Biomechanical comparison of screws and plates for hallux valgus opening-wedge and Ludloff osteotomies.

Journal Article

BACKGROUND: The optimal osteotomy type and fixation method for hallux valgus correction have not been defined. This study examined the mechanical properties of corrective opening-wedge and Ludloff oblique osteotomies under conditions approximating postoperative weight-bearing. METHODS: Twenty-nine pairs of fresh-frozen metatarsals were divided into three groups. In Group 1, headless screws were compared with standard cortical screws for Ludloff osteotomy fixation. In Groups 2 and 3, Ludloff osteotomies fixed with headless screws were compared with opening-wedge osteotomies fixed with non-locking and locking plates, respectively. Constructs underwent dorsally-directed cantilever loading for 1000 cycles. FINDINGS: No significant differences in angulation or stiffness were demonstrable in Group 1. In Group 2, Ludloff/headless screw construct stiffness exceeded non-locking plate construct stiffness. The mean angulation on the 1000th load cycle was greater for plates than for Ludloff/headless screws. In Group 3, locking plate construct stiffness and angulation did not differ from Ludloff/headless screws in early cyclic loading, but fixation failure of the locking plate constructs was common. INTERPRETATION: The results indicate that screw type for Ludloff fixation may be left to surgeon preference and that opening-wedge plates exhibit mechanical properties inferior to that of the Ludloff osteotomy under the tested conditions. Lateral cortex continuity and bone density remain important factors in the performance of opening-wedge osteotomies.

Full Text

Duke Authors

Cited Authors

  • Hofstaetter, SG; Glisson, RR; Alitz, CJ; Trnka, HJ; Easley, ME

Published Date

  • January 2008

Published In

Volume / Issue

  • 23 / 1

Start / End Page

  • 101 - 108

PubMed ID

  • 17910899

International Standard Serial Number (ISSN)

  • 0268-0033

Digital Object Identifier (DOI)

  • 10.1016/j.clinbiomech.2007.08.012

Language

  • eng

Conference Location

  • England