Bohnert Laurent, Radeideh Ahmad, Bigolin Gianni, Gautier Emanuel, Lottenbach Marc
Orthopaedic Surgeon, Department of Orthopaedics, Luzerner Kantonsspital Sursee, Sursee, Switzerland.
Orthopaedic Surgeon, Orthopaedic Department, Jordan University of Science & Technology, Irbid, Jordan.
J Foot Ankle Surg. 2018 Nov-Dec;57(6):1056-1058. doi: 10.1053/j.jfas.2018.02.010.
The purpose of the present study was to biomechanically compare the primary stability of our formerly described inside-out plate fixation to the classic double screw fixation for scarf osteotomy in the treatment of hallux valgus. We performed 20 scarf osteotomies on first metatarsal composite bone models. One half were fixed using a double screw technique and the other half using a locking plate inside-out technique. Using a testing device to simulate the physiologic load, the specimen was loaded until failure, and the load at failure, displacement at failure, and work at failure were recorded. The results were compared between the 2 groups and against the findings from intact sawbones. Compared with the intact bone models, the energy absorption was low for both types of osteotomy fixation. Between the 2 fixation groups, the load at failure was greater for plate fixation, although the difference was not statistically significant (p = .051). However, a statistically significant difference was found between both groups comparing work and displacement at failure (p < .001). In conclusion, the formerly described inside-out plating technique is a biomechanically reasonable alternative to screw fixation because of its primary stability after scarf osteotomy for hallux valgus.
本研究的目的是对我们之前描述的由外向内钢板固定术与治疗拇外翻时经典双螺钉固定术用于Scarf截骨术的初始稳定性进行生物力学比较。我们在第一跖骨复合骨模型上进行了20例Scarf截骨术。一半采用双螺钉技术固定，另一半采用由外向内锁定钢板技术固定。使用测试装置模拟生理负荷，对标本加载直至失效，并记录失效时的负荷、失效时的位移和失效时的功。对两组结果进行比较，并与完整锯骨标本的结果进行对照。与完整骨模型相比，两种截骨固定方式的能量吸收均较低。在两个固定组之间，钢板固定的失效负荷更大，尽管差异无统计学意义（p = 0.051）。然而，两组在失效时的功和位移方面存在统计学显著差异（p < 0.001）。总之，由于其在拇外翻Scarf截骨术后的初始稳定性，之前描述的由外向内钢板固定技术是一种生物力学上合理的螺钉固定替代方法。
