Shereff M J, Sobel M A, Kummer F J
Division of Foot and Ankle Surgery, Milwaukee Regional Medical Center, Wisconsin.
Foot Ankle. 1991 Feb;11(4):208-11. doi: 10.1177/107110079101100404.
Five different types of osteotomies for the correction of the hallux valgus deformity were performed on dried human first metatarsal bones. These included the step-cut Mitchell osteotomy, a distal transverse osteotomy, a distal biplanar osteotomy, the Chevron osteotomy, and a basilar osteotomy. Each type of procedure was then fixed using a variety of clinically appropriate techniques including single K-wires, crossed K-wires, a single A-0 cancellous screw, a single A-0 cortical screw, and three different types of sutures. Specimens were placed in a test jig and physiological loads applied with a Materials Testing Systems servohydraulic testing machine (Minneapolis, Minnesota). No difference in stability was observed between the various types of osteotomies, except for the Chevron osteotomy, which did possess greater inherent stability. Fixation by screws or multiple K-wires provided the most stable configuration when compared to other methods. The postoperative regimen following first metatarsal osteotomy should take into account the relative stability of fixation. Cast immobilization and a nonweight-bearing status may be preferable after procedures characterized by less mechanical stability.
在干燥的人类第一跖骨上进行了五种不同类型的截骨术以矫正拇外翻畸形。这些截骨术包括阶梯状截骨的米切尔截骨术、远端横向截骨术、远端双平面截骨术、人字形截骨术和基底截骨术。然后使用多种临床适用技术对每种手术进行固定，包括单根克氏针、交叉克氏针、单根A-0松质骨螺钉、单根A-0皮质骨螺钉以及三种不同类型的缝线。将标本放置在测试夹具中，并使用材料测试系统伺服液压试验机（明尼阿波利斯，明尼苏达州）施加生理负荷。除人字形截骨术具有更大的固有稳定性外，各类型截骨术之间未观察到稳定性差异。与其他方法相比，螺钉或多根克氏针固定提供了最稳定的结构。第一跖骨截骨术后的康复方案应考虑固定的相对稳定性。对于机械稳定性较差的手术，石膏固定和不负重状态可能更为可取。
