Relationship between inclination angle of the transverse osteotomy line and the strength of hallux valgus orthopedic in Scarf osteotomy: analysis of three-dimensional bone reconstruction

doi:10.12307/2021.180

Abstract

Abstract: BACKGROUND: Scarf osteotomy is an osteotomy of the metatarsal shaft, and the orthopedic force is strong, and the effect of osteotomy is significant, but the orthopedic often fluctuates greatly due to the change of the vetex line of the osteotomy and the angle of the osteotomy, causing undercorrection or overcorrection. Three-dimensional reconstruction software has unique advantages in three-dimensional model reconstruction, osteotomy simulation and index measurement. Therefore, it is necessary to quantify the influence of the osteotomy angle of the Scarf osteotomy line on the strength of orthopedic.
OBJECTIVE: To analyze the influence of the inclination angle of the transverse osteotomy line on the strength of hallux valgus correction during Scarf osteotomy using 3-matic software.
METHODS: From May 2018 to September 2020, 14 patients diagnosed with hallux valgus were admitted to the Department of Foot and Ankle Surgery, Wuxi Ninth Hospital, Soochow University, with 21 feet, aged 22 to 76 years old. With the aid of a simulated weight-bearing stent, the simulated weight-bearing CT images of the feet of patients with hallux valgus were obtained. Three-dimensional bone model was constructed in Mimics software, imported in 3-matic software to simulate Scarf osteotomy of the first metatarsal, adjust the different osteotomy angles of the transverse osteotomy line to simulate osteotomy. The relevant indexes of postoperative hallux valgus were measured, and compared with the measurement results of the same individual and the same index. The changing trend of each measured value was analyzed.
RESULTS AND CONCLUSION: (1) The inclination angle of the transverse osteotomy line of Scarf osteotomy has significant differences with the hallux valgus angle change rate, first-second intermetatarsal angle change rate, lateral intermetatarsal angle change rate and metatarsal head height change rate (P < 0.05). (2) At the same time, the change rate of lateral intermetatarsal angle and metatarsal head height increased significantly when the inclination angle of the osteotomy line was in the range of 20°-25°, and the change rate of hallux valgus angle and intermetatarsal angle was significantly increased in the range of 15°-20°. (3) It is concluded that using computer-assisted technology for preoperative simulation planning to provide a personalized and precise method for the correction of hallux valgus deformity, which is beneficial to reduce the incidence of surgical complications such as metastatic metatarsalgia, and increase the intensity of osteotomy orthopedic and the safety of osteotomy, improve patient satisfaction, reduce the learning curve of surgeons, and provide guidance and theoretical basis for clinical surgical treatment of hallux valgus.

Key words: hallux valgus, digital technology, Scarf osteotomy, three-dimensional reconstruction, osteotomy angle

CLC Number:

Wang Wencheng, Zhang Xingfei, Xu Yajun. Relationship between inclination angle of the transverse osteotomy line and the strength of hallux valgus orthopedic in Scarf osteotomy: analysis of three-dimensional bone reconstruction[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(27): 4265-4270.

Figures/Tables 2

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