Objective To explore the influence of the distal lateral displacement distance of Chevron osteotomy on contact characteristics of the hallux valgus, so as to provide reference for selecting suitable displacement distance in clinical practice. Methods The contact force, peak pressure and contact area of each joint of the forefoot, midfoot and hindfoot were measured in normal foot, hallux valgus foot, the distal Chevron osteotomy of the hallux valgus after the lateral displacement of 2.0, 4.0, 6.0 mm in the neutral position of the ankle joint, respectively. The results were compared and analyzed. Results Compared with the normal foot, the contact force of the 1st tarsometatarsal joint (t=-3.33, P=0.02), the calcaneocuboid joint (t=-2.74, P=0.03) and the subtalar joint (posterior articular surface) (t=-2.89, P=0.03) of hallux valgus foot significantly increased. The peak pressure of the talonavicular joint (t=-2.73, P=0.03) and the calcaneocuboid joint (t=-2.74, P=0.03) of the hallux valgus foot increased significantly. After Chevron osteotomy was performed, with the increasing of lateral displacement distance of distal osteotomy, the contact force of the 1st tarsometatarsal joint and the calcaneocuboid joint of hallux valgus foot decreased gradually; the peak pressure of the the talonavicular joint and the calcaneocuboid joint of hallux valgus decreased gradually. Conclusions After Chevron osteotomy is performed on moderate hallux valgus foot, when the distal end of the first metatarsal osteotomy is displaced outward by 4mm or 6mm, it can effectively restore the distribution of some inter articular forces and alleviate the local stress concentration of some joints.
Key words
Hallux valgus; /
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Chevron osteotomy; /
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Contact force; /
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Peak pressure; /
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Contact area
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References
[1] Bascarević Z, Vukasinović ZS, Bascarević VD, et al. Hallux valgus[J]. Acta Chir Iugosl, 2011, 58(3):107-111.
[2] Acar B, Kose O, Turan A, et al. Comparison of bioabsorbable Magnesium versus Titanium screw fixation for modified distal Chevron osteotomy in hallux valgus[J]. Biomed Res Int, 2018, 2018:5242806. DOI: 10.1155/2018/5242806.
[3] Del VJ, Ghioldi ME, Chemes LN, et al. Percutaneous, intra-articular, chevron osteotomy (PeICO) for the treatment of mild-to-moderate hallux valgus: a case series[J]. Int Orthop, 2021,45(9):2251-2260. DOI: 10.1007/s00264-021-05111-4.
[4] Biz C, Fosser M, Dalmau-Pastor M, et al. Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up[J]. J Orthop Surg Res, 2016,11(1):157. DOI: 10.1186/s13018-016-0491-x.
[5] Zhang Q, Zhang Y, Huang J, et al. Effect of displacement degree of distal Chevron osteotomy on metatarsal stress: A finite element method[J]. Biology (Basel), 2022,11(1):127. DOI: 10.3390/biology11010127.
[6] Verdu-Roman C, Sanz-Reig J, Martinez-Gimenez E, et al. Plantar pressure improvement in moderate hallux valgus with modified chevron osteotomy: Clinical and radiographic outcomes[J]. Foot Ankle Surg, 2020,26(2):205-208. DOI: 10.1016/j.fas.2019.02.006.
[7] 张鹏，夏江，俞光荣，等. Evans手术对跟骰关节压力影响的生物力学研究[J]. 中国临床解剖学杂志, 2012, 30(3):337-341.
[8] Vora AM, Tien TR, Parks BG, et al. Correction of moderate and severe acquired flexible flatfoot with medializing calcaneal osteotomy and flexor digitorum longus transfer[J]. J Bone Joint Surg Am, 2006,88(8):1726-1734. DOI: 10.2106/JBJS.E.00045.
[9] Chen J, Black NR, Morris R, et al. Biomechanical comparison of a novel method of Tricortical Kirschner wire fixation of distal Chevron osteotomies of the first metatarsal Versus traditional Kirschner wire and Versus screw fixation[J]. Foot Ankle Spec, 2020:842266661. DOI: 10.1177/1938640020965339.
[10] Brogan K, Lindisfarne E, Akehurst H, et al. Minimally invasive and open distal Chevron osteotomy for mild to moderate hallux valgus[J]. Foot Ankle Int, 2016,37(11):1197-1204. DOI: 10.1177/107110071665 6440.
[11] Badwey TM, Dutkowsky JP, Graves SC, et al. An anatomical basis for the degree of displacement of the distal chevron osteotomy in the treatment of hallux valgus[J]. Foot Ankle Int, 1997,18(4):213-215. DOI: 10.1177/107110079701800405.
[12] Matsumoto T, Gross CE, Parekh SG. Short-term radiographic outcome after distal Chevron osteotomy for hallux valgus using intramedullary plates with an amended algorithm for the surgical management of hallux valgus[J]. Foot Ankle Spec, 2019,12(1):25-33. DOI:10.1177/1938640018762474.
[13] Capurro B, Reina F, Carrera A, et al. Hip labral reconstruction with a polyurethane scaffold: restoration of femoroacetabular contact biomechanics[J]. Orthop J Sports Med, 2022,10(9):951723887. DOI:10.1177/23259671221118831.
[14]Berger L, Pahr D, Synek A. Articular contact vs. embedding: Effect of simplified boundary conditions on the stress distribution in the distal radius and volar plate implant loading[J]. J Biomech, 2022,143:111279. DOI:10.1016/j.jbiomech.2022.111279.
[15]马冬，王镱凝，徐楚江，等. 肌力对足关节接触特征影响的生物力学研究[J]. 医用生物力学, 2022, 网络首发地址：https://kns.cnki.net/kcms/detail/31.1624.r.20220919.1744.004.html.
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