Highlights
- •A modified fixation for Ludloff osteotomy is proposed utilizing a mini locking plate.
- •Fourth generation composite 1st metatarsals underwent quasi-static monotonic load up to failure or fatigue (cyclic) tests.
- •The specimens were tracked using an optical system for 3D Digital Image Correlation.
- •The developed osteotomy gap was significantly lower in the modified fixation group.
- •The lateral angle change was significantly lower in the modified fixation group.
Abstract
Background
The Ludloff oblique osteotomy is inherently unstable, which might lead to delayed
union and loss of correction. Supplementary fixation to two lag screw fixation has
been proposed. The hypothesis is that the osteotomy fixation constructs supplemented
by a mini locking plate provide greater resistance to osteotomy gaping and loss of
angular correction in response to cyclic loading.
Methods
Twenty fourth generation composite 1st metatarsals were used and underwent a Ludloff
osteotomy. They were divided in two fixation groups: two lag screws (Group A), and
with a supplementary mini locking plate (Group B). Specimens were subjected to either
monotonic loading up to failure or to fatigue (cyclic) tests and tracked using an
optical system for 3D Digital Image Correlation.
Findings
The osteotomy gap increased in size under maximum loading and was significantly greater
in Group A throughout the test. This increase was observed very early in the loading
process (within the first 1000 cycles). The most important finding though, was that with the specimens completely
unloaded the residual gap increase was significantly greater in Group A after only
5000 cycles of loading up to the completion of the test. The lateral angle change under
maximum loading was also significantly greater in Group A throughout the test, with
that increase observed early in the loading process (5000 cycles). With the specimens completely unloaded the residual lateral angle change
was also significantly greater in Group A at the completion of the test.
Interpretation
Supplementary fixation with a mini locking plate of the Ludloff osteotomy provided
greater resistance to osteotomy gaping and loss of angular correction compared to
sole lag screws, in response to cyclic loading.
Keywords
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Article info
Publication history
Published online: June 06, 2017
Accepted:
June 5,
2017
Received:
May 14,
2016
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
