Department of Orthopedic Surgery, Acibadem University Faculty of Medicine, Istanbul, Turkey.
Faculty of Mechanical Engineering Istanbul, Istanbul Technical University, Istanbul, Turkey.
J Foot Ankle Res. 2024 Sep;17(3):e12046. doi: 10.1002/jfa2.12046.
Chevron osteotomy offers near-excellent clinical results and adequate stability at lower shift percentages, among the techniques used to correct hallux valgus deformity. This cadaveric study aimed to compare the Chevron osteotomy with the reverse offset-L osteotomy, which may provide a greater surface area and a more stable geometry to withstand higher cantilever forces at higher shift percentages.
Metatarsal bones obtained from 20 human cadavers with similar bone quality were divided into two groups: Chevron osteotomy was applied to the 1st group and reverse offset-L osteotomy was applied to the 2nd group. The load-to-failure, displacement in the y-axis, and total displacement values of both groups were compared statistically. Furthermore, bone densities were compared between the groups with computed tomography imaging.
When outliers in both groups were excluded, a statistically significant difference was found in favor of reverse offset-L (143 ± 42 vs. 204 ± 51.2 N, p = 0.02) in terms of failure load. The groups were similar in terms of displacement on the y-axis and total displacement values. Bone densities were similar.
The reverse offset-L osteotomy has been shown to withstand greater loads before failure compared to the standard Chevron osteotomy. This significant difference in load-to-failure may enable reverse offset-L to provide reliable stability in osteotomies performed in advanced HV cases requiring higher shifts.
在用于矫正拇外翻畸形的技术中，Chevron 截骨术具有近乎卓越的临床效果和较低移位百分比时的足够稳定性。本尸体研究旨在比较 Chevron 截骨术与反向-offset-L 截骨术，后者可能提供更大的表面积和更稳定的几何形状，以承受更高移位百分比时更高的悬臂力。
从 20 具具有相似骨质量的人体尸体中获得跖骨，将其分为两组：第一组应用 Chevron 截骨术，第二组应用反向-offset-L 截骨术。对两组的破坏载荷、y 轴位移和总位移值进行统计学比较。此外，通过计算机断层扫描成像比较两组之间的骨密度。
当排除两组中的异常值后，在破坏载荷方面，反向-offset-L（143 ± 42 与 204 ± 51.2 N，p = 0.02）具有统计学显著差异。两组在 y 轴位移和总位移值方面相似。骨密度相似。
与标准 Chevron 截骨术相比，反向-offset-L 截骨术在失效前能够承受更大的载荷。这种破坏载荷的显著差异可能使反向-offset-L 在需要更高移位的高级 HV 病例中进行的截骨术中提供可靠的稳定性。
