Ma Dong, Wang Yining, Xu Chujiang, Dai Jingxing, Feng Zhengkuan, Yu Wanqi, Xu Guangwei, Xiao Jin, Zhong Shizhen, Jun Ouyang, Qian Lei
Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics & Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangzhou, Guangdong, China.
National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China.
Foot Ankle Int. 2025 Jun 29:10711007251344255. doi: 10.1177/10711007251344255.
Plantar displacement during chevron osteotomy may improve load distribution in hallux valgus, but biomechanical evidence is limited. This study evaluates how lateral and plantar displacement affect contact properties in the first metatarsophalangeal (MTP-1) and the first tarsometatarsal (TMT-1) joints under standing load.
Twelve cadaveric feet with hallux valgus and 4 normal specimens were tested under simulated standing load. Biplane osteotomy was performed with lateral displacement (2, 4, 6 mm) and plantar displacement (0, 2, 4 mm). Joint contact metrics were measured using Tekscan sensors.
Lateral displacement significantly affected contact force and peak pressure at both joints ( < .01). Interaction effects between lateral and plantar displacement were also significant ( < .01). A combination of 4-mm lateral and 2-4-mm plantar displacement most closely approximated contact pressures seen in the normal group.
Lateral displacement of 4 mm with 2-4 mm plantar shift optimizes contact pressure restoration in cadaveric hallux valgus feet. These findings offer biomechanical guidance but require clinical validation.
Understanding how lateral and plantar displacement affect joint biomechanics provides a foundational framework for refining surgical planning in biplane chevron osteotomy. By identifying displacement combinations that approximate normal joint pressures, this study offers biomechanical guidance to help reduce postoperative complications such as transfer metatarsalgia. However, clinical studies are needed to determine whether these biomechanical findings translate into improved outcomes in patients with hallux valgus.
人字形截骨术中的跖侧移位可能会改善拇外翻的负荷分布，但生物力学证据有限。本研究评估了在站立负荷下，外侧和跖侧移位如何影响第一跖趾关节（MTP-1）和第一跗跖关节（TMT-1）的接触特性。
对12例患有拇外翻的尸体足和4例正常标本在模拟站立负荷下进行测试。采用双平面截骨术，进行外侧移位（2、4、6毫米）和跖侧移位（0、2、4毫米）。使用Tekscan传感器测量关节接触指标。
外侧移位对两个关节的接触力和峰值压力均有显著影响（P＜0.01）。外侧和跖侧移位之间的交互作用也很显著（P＜0.01）。4毫米的外侧移位与2 - 4毫米的跖侧移位相结合，最接近正常组的接触压力。
4毫米的外侧移位与2 - 4毫米的跖侧移位可优化尸体拇外翻足的接触压力恢复。这些发现提供了生物力学指导，但需要临床验证。
了解外侧和跖侧移位如何影响关节生物力学，为改进双平面人字形截骨术的手术规划提供了基础框架。通过确定接近正常关节压力的移位组合，本研究提供了生物力学指导，以帮助减少诸如转移性跖骨痛等术后并发症。然而，需要进行临床研究来确定这些生物力学发现是否能转化为拇外翻患者更好的治疗效果。
