Cottom James M, Baker Joseph S
Florida Orthopedic Foot & Ankle Center, Sarasota, Florida.
Foot Ankle Spec. 2017 Jun;10(3):227-231. doi: 10.1177/1938640016676341. Epub 2016 Nov 11.
Arthrodesis of the first metatarsal cuneiform joint, or Lapidus procedure, is a widely accepted treatment for hallux valgus. Recent studies have focused on comparing various constructs for this procedure both in the laboratory and clinical settings. The current study compared in a cadaveric model the strength of 2 constructs. The first construct utilized a medially applied low-profile locking plate and an interfragmentary screw directed from plantar-distal to dorsal-proximal. The second construct consisted of a plantarly applied plate with a compression screw placed through the plate from plantar-distal to dorsal-proximal. The ultimate load to failure for the 2 groups tested was 255.38 ± 155.38 N and 197.48 ± 108.61 N, respectively (P = .402). There was no significant difference found between the 2 groups with respect to ultimate load to failure, stiffness of the construct, or moment at time of failure. In conclusion, the medially applied plate with plantar interfragmentary screw appears to be stronger than the plantar Lapidus plate tested for first metatarsal cuneiform arthrodesis, though this difference did not reach statistical significance.
Level V: Biomechanical Study.
第一跖楔关节融合术,即拉皮德斯手术,是治疗拇外翻广泛接受的一种方法。最近的研究集中在实验室和临床环境中比较该手术的各种固定方式。本研究在尸体模型中比较了两种固定方式的强度。第一种固定方式使用内侧应用的低轮廓锁定钢板和一枚从跖远端向背近端置入的骨折块间螺钉。第二种固定方式由一枚足底应用的钢板和一枚从跖远端向背近端穿过钢板置入的加压螺钉组成。测试的两组的最终破坏载荷分别为255.38±155.38N和197.48±108.61N(P = 0.402)。两组在最终破坏载荷、固定方式的刚度或破坏时的力矩方面均未发现显著差异。总之,对于第一跖楔关节融合术,内侧应用钢板加足底骨折块间螺钉似乎比测试的足底拉皮德斯钢板更强,尽管这种差异未达到统计学意义。
V级:生物力学研究。