The effect of screw type on the biomechanical properties of SCARF and crescentic osteotomies of the first metatarsal

Popoff, Ivan; Negrine, John; Zecovic, Milan; Svehla, M.; Walsh, William R.

doi:10.1016/s1067-2516(03)70021-0

Cited by 16 publications

(10 citation statements)

References 22 publications

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“…This, combined with the stress raiser effect of the osteotomy corner, make this location particularly vulnerable to fracture. This is in accordance with a previous in vitro study, where all bones operated with the scarf failed by fracture of the proximal dorsal bridge (Popoff, 2003). Using high speed video, we could identify that this failure originated at the proximal apex.…”

Section: Scarf Osteotomysupporting

confidence: 92%

Biomechanical consequences of first metatarsal osteotomy in treating hallux valgus

Favre

Farine

Snedeker

et al. 2010

Clinical Biomechanics

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This is the first study to investigate the cortical bone strain changes induced by these invasive osteotomies. Alterations from the intact bone response could be directly related to the design of the osteotomy. Notably, the critical weakening proximal apex of the scarf is avoided in the reversed-L, leading to results comparable to the chevron. This study provides support in favor of the intermediate design of the reversed-L as an effective compromise between the competing biomechanical objectives of corrective potential and mechanical stability.

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Section: Scarf Osteotomysupporting

confidence: 92%

Biomechanical consequences of first metatarsal osteotomy in treating hallux valgus

Favre

Farine

Snedeker

et al. 2010

Clinical Biomechanics

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“…Poppof et al 15 examined the mechanical properties of the Scarf osteotomy of the first metatarsal by using a cannulated asymmetric pitched screw and AO cancellous screws. Sixteen human cadaveric first metatarsal specimens were tested in plantar to dorsiflexion cantilever bending.…”

Section: Discussionmentioning

confidence: 99%

Minifragment Screw Fixation of the Scarf Osteotomy

Gupta¹,

Fazal²,

Williams³

2008

Foot Ankle Int.

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“…46,53 This osteotomy has a high degree of inherent biomechanical stability and is more stable than the basal osteotomies. 54,55 Studies have shown that the clinical outcomes of the scarf osteotomy compare favourably with those of basal osteotomies, but there is an incidence of significant complications of between 4% and 11%. 46,47,56 However, other studies have reported less favourable results with a much higher incidence of complications, 57 indicating that it is a technically-demanding procedure with a learning curve.…”

Section: Diaphyseal Osteotomiesmentioning

confidence: 99%

Modern concepts in the treatment of hallux valgus

Robinson

Limbers

2005

The Journal of Bone and Joint Surgery. British volume

314

177

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More than 130 operations have been described for the treatment of hallux valgus. The plethora of techniques indicates that no single operation is perfect, and none will address all cases. Treatment which is poorly planned or executed leads to high levels of patient dissatisfaction. In recent years, a number of new osteotomies have been described. Determining which to use can be difficult. This review will examine the important factors in choosing the most appropriate techniques. Aetiology and pathogenesisThe wearing of constricting and high heel shoes are extrinsic factors which are important in the development of hallux valgus. 1,2 Heredity is likely to be a major predisposing factor in some patients, with up to 68% of patients showing a familial tendency. 3 The role of pes planus is complex. It is unlikely that it is an important initiating factor in hallux valgus but in the presence of pes planus the progression of hallux valgus is more rapid. This is particularly so in those patients with a compromised medial joint capsule as in rheumatoid arthritis, collagen deficiency or a neuromuscular disorder. 4 The presence of pes planus does not reduce the rate of success of operations for hallux valgus. 5,6 Hypermobility of the first tarsometatarsal joint is thought by some 7,8 to be a causative component in some cases of hallux valgus. In these patients a fusion of the first tarsometatarsal joint (the Lapidus procedure), should be considered for surgical correction as opposed to an osteotomy. There is a correlation between hypermobility of the first ray and hallux valgus, 8-10 and a higher incidence of hypermobility at this site causes a hallux valgus deformity which is painful. 8,11 The accurate clinical assessment of hypermobility of the first ray is difficult. 9 However, a recent cadaver study 12 has shown that correction of a hallux valgus deformity by a distal soft-tissue procedure and a basal crescentic osteotomy significantly reduces hypermobility of the first ray, implying that the hypermobility maybe a secondary phenomenon in some cases.The pathogenesis of hallux valgus has been well described by Stephens. 13 Weakening of the tissues on the medial side of the first metatarsophalangeal joint and erosion of the ridge on the metatarsal head between the medial and lateral sesamoids occur early (Fig. 1). The proximal phalanx drifts into valgus and the metatarsal head into varus. A groove appears on the medial side of the articular cartilage of the metatarsal head as it atrophies from the lack of normal pressure and this gives rise to the apparent prominence of the medial exostosis. The medial bursa develops in response to the excessive pressure of shoes over this prominence. As the soft tissues on the medial side become further attenuated, the metatarsal head moves medially so that the medial sesamoid lies under the eroded metatarsal ridge and the lateral sesamoid articulates with the lateral side of the metatarsal head in the first intermetatarsal space. The tendons of extensor hallucis longus and flexor halluci...

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The effect of screw type on the biomechanical properties of SCARF and crescentic osteotomies of the first metatarsal

Cited by 16 publications

References 22 publications

Biomechanical consequences of first metatarsal osteotomy in treating hallux valgus

Biomechanical consequences of first metatarsal osteotomy in treating hallux valgus

Minifragment Screw Fixation of the Scarf Osteotomy

Modern concepts in the treatment of hallux valgus

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