A new “tension side” locking plate for Hallux Valgus surgery

NewsBot · Jun 4, 2015

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A new “tension side” locking plate for Hallux Valgus: A prospective multicentre case series
Daniel Goldbloom, Nilesh Makwan, , Patrick Laing, Eric Toullec, Wilfrid Graff, Antoine Charbel
Foot and Ankle Surgery; Available online 3 June 2015

Highlights
•Prospective multicentre international series for moderate to severe Hallux Valgus.
•Locking plate applied to the plantar surface of the metatarsal for basal osteotomy.
•Radiological, clinical and functional results comparable with similar series.
•Complications included 3 plate breakages.
•Statistically significant improvement in AOFAS-HMI and VAS measurements.
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Background
Proximal osteotomy of the first metatarsal is often indicated for Hallux Valgus correction. Previously recognised complications however, include transfer metatarsalgia, first metatarsophalangeal joint stiffness, problems with fixation and prominence of metalware.

Methods
We report on one year follow up of an international prospective series between June 2009 and October 2012 involving three centres, including 91 feet (58 patients) that underwent proximal osteotomy, using a new locking plate applied to the plantar surface of the metatarsal.

Results
Mean Hallux Valgus angle improved from 27.9(±13.1)degrees to 12.4 (±8.2) while mean Intermetatarsal angle improved from 12.5 (±8.4) to 7.1 (±3.4) and there was a statistically significant improvement in both mean AOFAS-HMI score 54.2 (±13.9) to 94.0(±9.5) and Visual Analogue Pain Scale 4.7(±1.5) to 0.6(±1.3). 70% of patients were back at their preoperative employment at five weeks. Mean surgical time was 56 minutes and the plate was generally well tolerated. There were five implant related complications.

Conclusion
Locked fixation from the tension side of the construct encourages early weight bearing with a low risk of implant prominence. Our radiological, functional and clinical parameters are comparable with similar series and we therefore recommend this technique.
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NewsBot · May 22, 2017

Biomechanical study on surgical fixation methods for minimally invasive treatment of hallux valgus.
Mao R et al
Med Eng Phys. 2017 May 17.

Hallux valgus (HV) was one of the most frequent female foot deformities. The aim of this study was to evaluate mechanical responses and stabilities of the Kirschner, bandage and fiberglass fixations after the distal metatarsal osteotomy in HV treatment. Surface traction of different forefoot regions in bandage fixation and the biomechanical behavior of fiberglass bandage material were measured by a pressure sensor device and a mechanical testing, respectively. A three-dimensional foot finite element (FE) model was developed to simulate the three fixation methods (Kirschner, bandage and fiberglass fixations) in weight bearing. The model included 28 bones, sesamoids, ligaments, plantar fascia, cartilages and soft tissue. The peak Von Mises stress (MS) and compression stress (CS) of the distal fragment were predicted from the three fixation methods: Kirschner fixation (MS=6.71MPa, CS=1.232MPa); Bandage fixation (MS=14.90MPa, CS=9.642MPa); Fiberglass fixation (MS=15.83MPa, CS=19.70MPa). Compared with the Kirschner and bandage fixation, the fiberglass fixation reduced the relative movement of osteotomy fragments and obtained the maximum CS. We concluded that fiberglass fixation in HV treatment was helpful to the bone healing of distal fragment. The findings were expected to guide further therapeutic planning of HV patient.
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