Biomechanical comparison of conventional versus modified technique in distal chevron osteotomies of the first metatarsal: A cadaver study

• Published in: Foot and ankle surgery 2019-10, Vol.25 (5), p.665-669
• Main Authors: Trost, Matthias, Knieps, Matthias, Loweg, Lennard, Neiss, Wolfram Friedrich, Eysel, Peer, Frey, Sönke, Schulte, Tobias Ludger, Bredow, Jan
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomechanical; Biomechanical Phenomena; Cadaver; Cadaver study; Chevron osteotomy; Conventional; Female; First metatarsal; Hallux valgus; Hallux Valgus - surgery; Humans; Male; Metatarsal Bones - surgery; Modified; Osteotomy - methods; Stress, Mechanical
• ISSN: 1268-7731; 1460-9584
• DOI: 10.1016/j.fas.2018.07.009

•Distal chevron osteotomy can be performed in a conventional or a modified technique.•Using the conventional technique, the average failure strength was 235N.•Using the modified technique, the average failure strength was 210N.•Both techniques showed a comparable biomechanical loading capacity. Distal chevron osteotomy can be performed using a conventional or a modified technique. The aim of this biomechanical study was to compare the stability of the two techniques. Eighteen first metatarsals from nine pairs of fresh frozen human cadaver feet were used. A distal chevron osteotomy was performed using the conventional technique in group 1 (n=9) and using the modified technique in group 2 (n=9). The head of the first metatarsals was loaded in two different configurations (cantilever and physiological), using a materials testing machine. In the cantilever configuration, the relative stiffness of the osteosynthesis in comparison with intact bone was 60% (±21%) in group 1 and 65% (±25%) in group 2 (p=0.61). In the physiological configuration, it was 47% (±29%) in group 1 and 47% (±21%) in group 2 (p=0.98). The failure strength in the cantilever configuration was 235N (±128N) in group 1 and 210N (±107N) in group 2 (p=0.47). The conventional and the modified technique for distal chevron osteotomy in the treatment of hallux valgus show a comparable biomechanical loading capacity in this cadaver study.