Fixation of the offset V osteotomy: Mechanical testing of 4 constructs

Khuri, Jane; Wertheimer, Stuart J.; Krueger, Jill; Haut, Roger C.

doi:10.1016/s1067-2516(03)70003-9

Cited by 15 publications

(6 citation statements)

References 17 publications

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“…For this reason, absolute values obtained with Sawbones certainly do not correspond to those measured in fresh-frozen metatarsals. However, previous studies, 13,20,22,24,26 suggested a sufficient reliability of Sawbones for comparison of relative stability, even though absolute values were not clinically relevant. Our goal was to compare the mechanical behavior of different geometric assemblies, so we showed only relative values from the mechanical testing, all related to the values measured on the nonosteotomized metatarsal Sawbones model.…”

Section: Discussionmentioning

confidence: 89%

“…The main limitation of the study was the use of Sawbones models instead of cadaver specimens. Sawbones do not simulate the viscoelastic properties of bone, 2,10,13,22,24 -26 and Landsman and Cheng 24 stated that the mechanical strength of cadaver bone is superior to the Sawbones model. For this reason, absolute values obtained with Sawbones certainly do not correspond to those measured in fresh-frozen metatarsals.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparative Mechanical Testing of Different Geometric Designs of Distal First Metatarsal Osteotomies

Vienne¹,

Favre²,

Meyer³

et al. 2007

Foot Ankle Int.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Comparative Mechanical Testing of Different Geometric Designs of Distal First Metatarsal Osteotomies

Vienne¹,

Favre²,

Meyer³

et al. 2007

Foot Ankle Int.

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“…A load in the plantar-to-dorsal direction was applied to the head of the first metatarsal. The cantilever configuration represents the most frequently used and well-established experimental set-up for biomechanical investigation of osteotomies of the first metatarsal (1)(2)(3)(4)(5)14,(19)(20)(21)(22)(23). It simulates the anatomic position of the first metatarsal during standing and investigates the effect of the ground reaction force.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical Comparison of Fixation With a Single Screw Versus Two Kirschner Wires in Distal Chevron Osteotomies of the First Metatarsal: A Cadaver Study

Trost

Bredow²,

Boese

et al. 2018

The Journal of Foot and Ankle Surgery

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Distal chevron osteotomy is a common procedure for surgical correction of hallux valgus. Osteosynthesis with 1 screw or 2 Kirschner wires has been commonly used. We compared the stability of the 2 techniques in distal chevron osteotomy. Sixteen first metatarsals from fresh-frozen human cadaver feet (9 different cadaveric specimens) were used. A standardized distal chevron osteotomy was performed. One first metatarsal from each pair was assigned to group 1 (3.5-mm cortical screw; n = 8) and one to group 2 (two 1.6-mm Kirschner wires; n = 8). Using a materials testing machine, the head of the first metatarsals was loaded in 2 different configurations (cantilever and physiologic) in succession. In the cantilever configuration, the relative stiffness of the osteosynthesis compared with intact bone was 59% ± 27% in group 1 and 68% ± 18% in group 2 (p = .50). In the physiologic configuration, it was 38% ± 25% in group 1 and 35% ± 7% in group 2 (p = .75). The failure strength in the cantilever configuration was 187 ± 105 N in group 1 and 259 ± 71 N in group 2 (p = .21). No statistically significant differences were found in stability between the 2 techniques. The use of 1 screw or 2 Kirschner wires had no significant differences in their biomechanical loading capacity for osteosynthesis in distal chevron osteotomies for treatment of hallux valgus.

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“…Although the chevron is described as an inherently stable osteotomy, there have been concerns over displacement, and thus, numerous ways exist to obtain fixation including K-wires, screws, sutures, staples, and plates. [16][17][18][19][20] There have been several studies comparing various configurations of K-wire and screw constructs. 10,14,18,21 Despite the various methods tested, two of the most commonly used methods remain the traditional unicortical K-wire fixation and single-screw fixation.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Comparison of a Novel Method of Tricortical Kirschner Wire Fixation of Distal Chevron Osteotomies of the First Metatarsal Versus Traditional Kirschner Wire and Versus Screw Fixation

Jie

Black

Morris

et al. 2020

Foot & Ankle Specialist

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Introduction: Traditional Kirschner wire (K-wire) stabilization of first metatarsal distal chevron osteotomy involves 1 cortex of fixation; however, unicortical fixation is associated with a high complication rate, including pin migration. A method of K-wire fixation utilizing 3 cortices may be biomechanically superior and potentially equivalent to single-screw fixation. Methods: Cadaveric specimens fixed with tricortical K-wires were tested in both the physiologic and cantilever conditions against specimens fixed with unicortical K-wires (N = 8) and single screws (N = 9) utilizing matched-pair comparison groups. Differences in physiologic and cantilever fixed/intact stiffness ratio and cantilever failure load were determined. Results: The tricortical fixation specimens had a significantly higher stiffness ratio in cantilever loading than the unicortical fixation specimens (60.50% tricortical, 34.17% unicortical, P = .02) but not in physiologic load (15.34% tricortical, 25.75% unicortical, P = .23). In cantilever failure loading, the tricortical fixation specimens had a significantly higher load to failure than the unicortical fixation specimens (132.81 N tricortical, 58.58 N unicortical, P < .01). Stiffness ratio under physiologic load, cantilever load, and ultimate load to failure were not significantly different between tricortical K-wire and screw-fixation groups. Conclusion: Tricortical K-wire fixation for distal chevron osteotomies is biomechanically superior to traditional unicortical K-wire fixation, and equivalent to single-screw fixation. Levels of Evidence: Level V: Cadaver study

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Fixation of the offset V osteotomy: Mechanical testing of 4 constructs

Cited by 15 publications

References 17 publications

Comparative Mechanical Testing of Different Geometric Designs of Distal First Metatarsal Osteotomies

Comparative Mechanical Testing of Different Geometric Designs of Distal First Metatarsal Osteotomies

Biomechanical Comparison of Fixation With a Single Screw Versus Two Kirschner Wires in Distal Chevron Osteotomies of the First Metatarsal: A Cadaver Study

Biomechanical Comparison of a Novel Method of Tricortical Kirschner Wire Fixation of Distal Chevron Osteotomies of the First Metatarsal Versus Traditional Kirschner Wire and Versus Screw Fixation

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